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

研究成果: Contribution to journalArticle査読

37 被引用数 (Scopus)

抄録

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.

本文言語英語
ページ(範囲)231-237
ページ数7
ジャーナルClinical nephrology
58
3
DOI
出版ステータス出版済み - 9 2002

All Science Journal Classification (ASJC) codes

  • 腎臓病学

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