Minimal-change nephrotic syndrome in a hematopoietic stem-cell transplant recipient.
BACKGROUND
A 61-year-old woman received standard immunizations, including Haemophilus influenzae type B, diphtheria, tetanus toxoid, and unconjugated 23-valent pneumococcal vaccine (Pneumovax), Merck & Co., Inc., Whitehouse Station, NJ), 1 year after undergoing nonmyeloablative hematopoietic stem-cell transplantation for acute myelogenous leukemia. After 5 days, she developed fatigue with progressive weight gain and edema, and 14 days after immunization she presented with anasarca and was found to have acute renal failure and nephrotic proteinuria.


METHODS
Physical examination, serum chemistry, examination of urine sediment, renal ultrasound using Doppler scanning, 24 h urine collection, and renal biopsy.


METHODS
Minimal-change nephrotic syndrome with acute tubular injury.


RESULTS
Aggressive diuresis and oral corticosteroid therapy.
Humphreys
Benjamin D
BD
Harvard Medical School, Boston, MA 02115, USA. bhumphreys@partners.org
Vanguri
Vijay K
VK
Henderson
Joel
J
Antin
Joseph H
JH
D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007114:Immunization / Q000009:adverse effects*; D007668:Kidney / Q000473:pathology; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy