title: Hematopoietic Stem Cell Transplantation Nephropathy Associated with Chronic Graft-versus-Host Disease without Extrarenal Involvement.
abstract: A 30-year-old woman with myelodysplastic syndrome underwent allogeneic hematopoietic stem cell transplantation (HSCT) derived from her HLA-matched sister six years previously. She received preconditioning total body irradiation with renal shielding and was subsequently administered cyclosporin A (CyA) as prophylaxis against graft-versus-host disease (GVHD). Four months after HSCT, asymptomatic proteinuria and glomerular hematuria developed during CyA tapering without obvious extrarenal involvements of GVHD, and persisted for six years. A renal biopsy revealed endothelial injury in the glomeruli, and the deposition of C4d was detected diffusely on glomerular capillaries and focally on peritubular capillaries, suggesting that nephropathy involved antibody- or complement-associated immune reactions.
authors.affiliation: Division of Nephrology, Department of Medicine, Kyoto Prefecture University of Medicine, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Ishida
authors.forename: Akira
authors.initials: A
authors.lastname: Shimizu
authors.forename: Takashi
authors.initials: T
authors.lastname: Kitani
authors.forename: Mayumi
authors.initials: M
authors.lastname: Nakata
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Ota
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kado
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Shiotsu
authors.forename: Mami
authors.initials: M
authors.lastname: Ishida
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tamagaki
mesh_terms: D000328:Adult; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology* / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology*; D007678:Kidney Glomerulus / Q000473:pathology; D008297:Male; D011507:Proteinuria / Q000150:complications
chemical_list: D016572:Cyclosporine