Nephrotic syndrome in a child after umbilical-cord-blood transplantation.
We report a 12-year-old girl who developed nephrotic syndrome 6 months after umbilical-cord-blood transplantation (UCBT) for acute lymphoblastic leukemia (L2). In addition to nephrotic syndrome, she also showed autoimmune hemolytic anemia, thrombocytopenia and gastrointestinal symptoms. Since these symptoms were manifested during the course of tapering immunosuppressive agents, a diagnosis of chronic graft-versus-host disease (GVHD) was made. Findings from a kidney biopsy were compatible with minimal-change disease (MCD), and focal glomerular capillary thrombosis and mild tubular damage were also noted. She was treated with methylprednisolone pulse therapy followed by oral prednisolone. Proteinuria disappeared in 14 days. Gastrointestinal symptoms, anemia and thrombocytopenia were also corrected. This is a case report of nephrotic syndrome as a manifestation of chronic GVHD developed after stem-cell transplantation. A review of the cases reported in the literature is also made.
Lee
Joo Hoon
JH
Department of Pediatrics, Asan Medical Center, Seoul, South Korea.
Kwon
Bo Sang
BS
Ha
Il Soo
IS
Cheong
Hae Il
HI
Moon
Kyung Chul
KC
Ahn
Hyo Seop
HS
Choi
Yong
Y
D000293:Adolescent; D000328:Adult; D002648:Child; D036101:Cord Blood Stem Cell Transplantation; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000209:etiology / Q000276:immunology / Q000503:physiopathology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy
D007166:Immunosuppressive Agents