A case of chronic kidney disease with thrombotic microangiopathy in a hematopoietic stem cell transplant recipient.
A 23-year-old Japanese man who had undergone hematopoietic stem cell transplantation for acute lymphocytic leukemia from an HLA-identical sibling 6 years earlier developed proteinuria and impaired kidney function. Kidney biopsy revealed thrombotic microangiopathy with a moderate increase in mesangial matrices and glomerular microaneurysm featuring retention of red blood cells. The patient's kidney function gradually deteriorated, requiring the institution of treatment with angiotensin II receptor blockers and angiotensin-converting enzyme inhibitors, and progressing to continuous ambulatory peritoneal dialysis 4 years after the initial kidney biopsy. Eventually, kidney transplantation was performed with his mother as the donor. His kidney function is stable on immunosuppressive drugs at 2 years after transplantation. This report reflects the growing number of patients with chronic kidney disease with thrombotic microangiopathy all over the world.
Maeda
Kunihiro
K
Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute-cyo, Aichi, 480-1195, Japan.
Suzuki
Keisuke
K
Mizutani
Motonori
M
Watanabe
Hitoshi
H
Suga
Norihiro
N
Kitagawa
Wataru
W
Miura
Naoto
N
Nishikawa
Kazuhiro
K
Uchida
Kazuharu
K
Imai
Hirokazu
H
D001706:Biopsy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000473:pathology / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000601:surgery; D057049:Thrombotic Microangiopathies / Q000209:etiology / Q000473:pathology; D055815:Young Adult
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