Fatal nephrotic syndrome complicating allogeneic stem cell transplantation: a case report.
Disturbed kidney function is a common occurrence after bone-marrow transplantation. Sepsis, nephrotoxic medications, thrombotic microangiopathy and injury related to haemodynamic alterations are frequently accountable. Recently, attention has been given to immune-mediated glomerular damage, related to graft-versus-host disease. Herein we describe the fatal course of a nephrotic syndrome complicating allogeneic stem cell transplantation in a young woman with long-standing paroxysmal nocturnal haemoglobinuria. A post-mortem kidney biopsy revealed amyloidosis of the AA type. Physicians should be aware of the possibility that infections and inflammation accompanying the post-transplantation period may rarely promote the development of systemic amyloidosis or exacerbate silent pre-existing disease.
Ben-Dov
Iddo Z
IZ
Hadassah-Hebrew University Medical Center, Jerusalem, Israel. iddobe@ekmd.huji.ac.il
Pizov
Galina
G
Ben-Chetrit
Eldad
E
Rubinger
Dvora
D
Or
Reuven
R
D000686:Amyloidosis / Q000150:complications / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006457:Hemoglobinuria, Paroxysmal / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000150:complications / Q000473:pathology; D009404:Nephrotic Syndrome / Q000209:etiology*; D014184:Transplantation, Homologous; D055815:Young Adult