Diffuse proliferative glomerulonephritis after bone marrow tansplantation

T. Suehiro, K. Masutani, M. Yokoyama, M. Tokumoto, K. Tsuruya, K. Fukuda, H. Kanai, R. Katafuchi, Y. Nagatoshi, H. Hirakata

Research output: Contribution to journalArticle

37 Citations (Scopus)

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 languageEnglish
Pages (from-to)231-237
Number of pages7
JournalClinical Nephrology
Volume58
Issue number3
Publication statusPublished - Sep 1 2002

Fingerprint

Glomerulonephritis
Bone Marrow
Kidney
Nephrotic Syndrome
Prednisolone
Bone Marrow Transplantation
Biopsy
Active Immunity
Membranous Glomerulonephritis
Liver
Homologous Transplantation
Methylprednisolone
Wounds and Injuries
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Proteinuria
Acute Kidney Injury
Cellular Immunity
Cyclophosphamide
Necrosis
Therapeutics

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Suehiro, T., Masutani, K., Yokoyama, M., Tokumoto, M., Tsuruya, K., Fukuda, K., ... Hirakata, H. (2002). Diffuse proliferative glomerulonephritis after bone marrow tansplantation. Clinical Nephrology, 58(3), 231-237.

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 journalArticle

Suehiro, T, Masutani, K, Yokoyama, M, Tokumoto, M, Tsuruya, K, Fukuda, K, Kanai, H, Katafuchi, R, Nagatoshi, Y & Hirakata, H 2002, 'Diffuse proliferative glomerulonephritis after bone marrow tansplantation', Clinical Nephrology, vol. 58, no. 3, pp. 231-237.
Suehiro T, Masutani K, Yokoyama M, Tokumoto M, Tsuruya K, Fukuda K et al. Diffuse proliferative glomerulonephritis after bone marrow tansplantation. Clinical Nephrology. 2002 Sep 1;58(3):231-237.
Suehiro, T. ; Masutani, K. ; Yokoyama, M. ; Tokumoto, M. ; Tsuruya, K. ; Fukuda, K. ; Kanai, H. ; Katafuchi, R. ; Nagatoshi, Y. ; Hirakata, H. / Diffuse proliferative glomerulonephritis after bone marrow tansplantation. In: Clinical Nephrology. 2002 ; Vol. 58, No. 3. pp. 231-237.
@article{634270ca43e049eda961ec615a8a41eb,
title = "Diffuse proliferative glomerulonephritis after bone marrow tansplantation",
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.",
author = "T. Suehiro and K. Masutani and M. Yokoyama and M. Tokumoto and K. Tsuruya and K. Fukuda and H. Kanai and R. Katafuchi and Y. Nagatoshi and H. Hirakata",
year = "2002",
month = "9",
day = "1",
language = "English",
volume = "58",
pages = "231--237",
journal = "Clinical Nephrology",
issn = "0301-0430",
publisher = "Dustri-Verlag Dr. Karl Feistle",
number = "3",

}

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 -