title: Membranous nephropathy after allogeneic hematopoietic stem cell transplantation in a patient with aplastic anemia: a case report.
abstract: Nephrotic syndrome has been described as one of the clinical forms of chronic graft-versus-host disease (cGVHD), but a limited number of cases have been described. We experienced a young female patient with nephrotic syndrome developed 22 months after allogeneic hematopoietic stem cell transplantation (HSCT) for severe aplastic anemia. She had been well after successful management for gut-limited cGVHD until she developed a clinical nephrotic syndrome with hypoalbuminemia of 2.0 g/dL and 24-hr urine protein of 6.88 g/dL. On physical examination and laboratory findings, there was no other evidence of cGVHD. Clinical and renal biopsy findings were consistent with cGVHD-related membranous nephropathy, and immunosuppressive agents with cyclosporine and prednisone were prescribed. After 3 month of treatment, the proteinuria decreased to normal range; and the patient from nephrotic syndrome nearly recovered. We recommend cGVHD-related glomerulonephritis should be considered in all patients with hypoalbuminemia following allogeneic HSCT, even if there is no other evidence of clinical GVHD.
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Kee Won
authors.initials: KW
authors.lastname: Kim
authors.forename: Chong Hyeon
authors.initials: CH
authors.lastname: Yoon
authors.forename: Chul Seung
authors.initials: CS
authors.lastname: Kay
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Kwang-Sun
authors.initials: KS
authors.lastname: Suh
authors.forename: Suk Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Suk Young
authors.initials: SY
authors.lastname: Park
mesh_terms: D000328:Adult; D000741:Anemia, Aplastic / Q000503:physiopathology / Q000628:therapy; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000209:etiology* / Q000473:pathology; D006086:Graft vs Host Disease / Q000503:physiopathology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007678:Kidney Glomerulus / Q000473:pathology