title: [Membranous nephropathy with nephrotic syndrome developed after allogeneic hematopoietic stem cell transplantation for acute lymphoblastic leukemia].
abstract: A 38-year-old man was diagnosed with acute lymphoblastic leukemia. We performed myeloablative bone marrow transplantation from an unrelated donor during the patient's first complete remission. After engraftment, he developed acute graft-versus-host disease involving the gastrointestinal tract on day 32. Steroids and mycophenolate mofetil were initiated from day 39. His symptoms improved and the dose of immunosuppressants was tapered and then discontinued on day 421. On day 491, he developed nephrotic syndrome (NS). Based on renal biopsy, membranous nephropathy was diagnosed. There were no apparent symptoms or abnormal laboratory data suggestive of chronic graft-versus-host disease (cGVHD). Steroid therapy was initiated from day 518 and proteinuria improved significantly. NS is very rare following allogeneic hematopoietic stem cell transplantation (allo-HSCT). When there is no concomitant cGVHD, as in this case, allo-HSCT-associated NS is difficult to distinguish from idiopathic NS.
authors.affiliation: Department of Hematology, Graduate School of Medicine, Osaka City University.
authors.forename: Mizuki
authors.initials: M
authors.lastname: Aimoto
authors.forename: Takahisa
authors.initials: T
authors.lastname: Yamane
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ichii
authors.forename: Katsuhito
authors.initials: K
authors.lastname: Mori
authors.forename: Ran
authors.initials: R
authors.lastname: Moriguchi-Aimoto
authors.forename: Eri
authors.initials: E
authors.lastname: Wada-Inoue
authors.forename: Hideo
authors.initials: H
authors.lastname: Koh
authors.forename: Takahiko
authors.initials: T
authors.lastname: Nakane
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Takeoka
authors.forename: Mika
authors.initials: M
authors.lastname: Akahori-Nakamae
authors.forename: Saori
authors.initials: S
authors.lastname: Nishiki-Kosaka
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Terada
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Nakamae
authors.forename: Ki-Ryang
authors.initials: KR
authors.lastname: Koh
authors.forename: Takafumi
authors.initials: T
authors.lastname: Nakao
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ohsawa
authors.forename: Kenichi
authors.initials: K
authors.lastname: Wakasa
authors.forename: Eiji
authors.initials: E
authors.lastname: Ishimura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Inaba
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hino
mesh_terms: D000208:Acute Disease; D000328:Adult; D003937:Diagnosis, Differential; D015433:Glomerulonephritis, Membranous / Q000175:diagnosis / Q000209:etiology*; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000175:diagnosis / Q000209:etiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D014184:Transplantation, Homologous