Abstract
A 15-year-old boy developed nephrotic syndrome and acute renal failure 4 years after allogenic bone marrow transplantation (BMT) for lymphoid crisis of chronic myelocytic leukemia. On admission, he presented with clinical features of chronic GVHD including transient exacerbation of cholestatic liver injury. Renal biopsy showed diffuse proliferative glomerulonephritis with cellular crescents. The patient was treated with methylprednisolone pulse therapy (1 g/day, for 3 days) followed by oral prednisolone. Renal function gradually improved but nephrotic state was persistent. A second renal biopsy showed improvement of acute tubular necrosis and endocapillary proliferation and transformation of crescents into a fibrous form. After tapering of oral prednisolone, cyclophosphamide was started, which resulted in a gradual improvement of proteinuria. Several cases of nephrotic syndrome occurring after BMT have already been reported, but most cases had membranous nephropathy. In our case, renal biopsy revealed diffuse proliferative glomerulonephritis with findings of active cellular immunity, and aggressive treatment resulted in attenuation of these findings. Moreover, chronic GVHD-related liver injury was noted at the time of this episode. Our findings suggest that chronic GVHD may be complicated with diffuse proliferative glomerulonephritis through unknown cellular immune mechanism.
| Original language | English |
|---|---|
| Pages (from-to) | 231-237 |
| Number of pages | 7 |
| Journal | Clinical Nephrology |
| Volume | 58 |
| Issue number | 3 |
| Publication status | Published - Sep 1 2002 |
Fingerprint
All Science Journal Classification (ASJC) codes
- Nephrology
Cite this
Diffuse proliferative glomerulonephritis after bone marrow tansplantation. / Suehiro, T.; Masutani, K.; Yokoyama, M.; Tokumoto, M.; Tsuruya, K.; Fukuda, K.; Kanai, H.; Katafuchi, R.; Nagatoshi, Y.; Hirakata, H.
In: Clinical Nephrology, Vol. 58, No. 3, 01.09.2002, p. 231-237.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Diffuse proliferative glomerulonephritis after bone marrow tansplantation
AU - Suehiro, T.
AU - Masutani, K.
AU - Yokoyama, M.
AU - Tokumoto, M.
AU - Tsuruya, K.
AU - Fukuda, K.
AU - Kanai, H.
AU - Katafuchi, R.
AU - Nagatoshi, Y.
AU - Hirakata, H.
PY - 2002/9/1
Y1 - 2002/9/1
N2 - A 15-year-old boy developed nephrotic syndrome and acute renal failure 4 years after allogenic bone marrow transplantation (BMT) for lymphoid crisis of chronic myelocytic leukemia. On admission, he presented with clinical features of chronic GVHD including transient exacerbation of cholestatic liver injury. Renal biopsy showed diffuse proliferative glomerulonephritis with cellular crescents. The patient was treated with methylprednisolone pulse therapy (1 g/day, for 3 days) followed by oral prednisolone. Renal function gradually improved but nephrotic state was persistent. A second renal biopsy showed improvement of acute tubular necrosis and endocapillary proliferation and transformation of crescents into a fibrous form. After tapering of oral prednisolone, cyclophosphamide was started, which resulted in a gradual improvement of proteinuria. Several cases of nephrotic syndrome occurring after BMT have already been reported, but most cases had membranous nephropathy. In our case, renal biopsy revealed diffuse proliferative glomerulonephritis with findings of active cellular immunity, and aggressive treatment resulted in attenuation of these findings. Moreover, chronic GVHD-related liver injury was noted at the time of this episode. Our findings suggest that chronic GVHD may be complicated with diffuse proliferative glomerulonephritis through unknown cellular immune mechanism.
AB - A 15-year-old boy developed nephrotic syndrome and acute renal failure 4 years after allogenic bone marrow transplantation (BMT) for lymphoid crisis of chronic myelocytic leukemia. On admission, he presented with clinical features of chronic GVHD including transient exacerbation of cholestatic liver injury. Renal biopsy showed diffuse proliferative glomerulonephritis with cellular crescents. The patient was treated with methylprednisolone pulse therapy (1 g/day, for 3 days) followed by oral prednisolone. Renal function gradually improved but nephrotic state was persistent. A second renal biopsy showed improvement of acute tubular necrosis and endocapillary proliferation and transformation of crescents into a fibrous form. After tapering of oral prednisolone, cyclophosphamide was started, which resulted in a gradual improvement of proteinuria. Several cases of nephrotic syndrome occurring after BMT have already been reported, but most cases had membranous nephropathy. In our case, renal biopsy revealed diffuse proliferative glomerulonephritis with findings of active cellular immunity, and aggressive treatment resulted in attenuation of these findings. Moreover, chronic GVHD-related liver injury was noted at the time of this episode. Our findings suggest that chronic GVHD may be complicated with diffuse proliferative glomerulonephritis through unknown cellular immune mechanism.
UR - http://www.scopus.com/inward/record.url?scp=0036712808&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036712808&partnerID=8YFLogxK
M3 - Article
C2 - 12356194
AN - SCOPUS:0036712808
VL - 58
SP - 231
EP - 237
JO - Clinical Nephrology
JF - Clinical Nephrology
SN - 0301-0430
IS - 3
ER -