title: Nephrotic syndrome after allogeneic hematopoietic stem cell transplantation: etiology and pathogenesis.
abstract: In this study we investigated the etiology and pathogenesis of nephrotic syndrome (NS) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in 257 patients with hematopoietic malignancies who survived more than 2 months post allo-HSCT. Associations of NS with the conditioning regimen, graft versus host disease (GVHD), and other variables were analyzed. Pathologic features of the kidney, regulatory T cells (Tregs), interferon-γ (IFN-γ), and tumor necrosis factor-α (TNF-α) were studied. NS was identified in 9 patients. The number of Tregs at day+30, 60, 90, and 180 was lower in NS patients than non-NS patients (P=0.001, 0.001, 0.007, 0.003). Serum levels of IFN-γ and TNF-α were higher in NS patients (P=0.032, 0.001, respectively). NS post allo-HSCT was associated with the occurrence of chronic GVHD (P=0.02). NS post-HSCT is an immune disorder that may involve immune complex deposition, Th1 cytokines, and Tregs.
authors.affiliation: Hematology Department, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
authors.forename: Xiao-dan
authors.initials: XD
authors.lastname: Luo
authors.forename: Qi-fa
authors.initials: QF
authors.lastname: Liu
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.forename: Jing
authors.initials: J
authors.lastname: Sun
authors.forename: Guo-bao
authors.initials: GB
authors.lastname: Wang
authors.forename: Zhi-ping
authors.initials: ZP
authors.lastname: Fan
authors.forename: Zheng-shan
authors.initials: ZS
authors.lastname: Yi
authors.forename: Yi-wen
authors.initials: YW
authors.lastname: Ling
authors.forename: Yong-qiang
authors.initials: YQ
authors.lastname: Wei
authors.forename: Xiao-li
authors.initials: XL
authors.lastname: Liu
authors.forename: Bing
authors.initials: B
authors.lastname: Xu
mesh_terms: D000328:Adult; D015703:Antigens, CD; D001706:Biopsy; D005260:Female; D006086:Graft vs Host Disease / Q000097:blood / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D019337:Hematologic Neoplasms / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007150:Immunohistochemistry; D007371:Interferon-gamma / Q000097:blood; D008297:Male; D009404:Nephrotic Syndrome / Q000209:etiology* / Q000473:pathology; D050378:T-Lymphocytes, Regulatory / Q000276:immunology; D014184:Transplantation, Homologous / Q000009:adverse effects*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015703:Antigens, CD; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma