Hematopoietic cell transplantation-related nephropathy

Arat, Mutlu; Arslan, Önder; Beksaç, Meral; Keven, Kenan; Nergızoğlu, Gökhan; Ertürk, Şehsuvar

doi:10.1053/ajkd.2001.26163

Cited by 5 publications

(2 citation statements)

References 3 publications

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“…Main individual findings of the reviewed 46 cases are listed in complementary Table 2. Other publications (44,45) refer to additional cases, but the details are too scarce to take these patients into account for detailed analysis in this review. In an additional case, NS developed after bone marrow nephropathy was found on renal histology, but the patient did not undergo biopsy again (46).…”

Section: Analysis Of the Literature And Discussionmentioning

confidence: 99%

Nephrotic Syndrome after Hematopoietic Cell Transplantation

Brukamp¹,

Doyle²,

Bloom³

et al. 2006

Clinical Journal of the American Society of Nephrology

135

134

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Glomerular disease associated with nephrotic syndrome has rarely been recognized as a distinct complication of allogeneic hematopoietic cell transplantation. Case reports in the English and Japanese literature since 1988 have described variable glomerular histology, comprising mainly membranous glomerulonephritis (MGN) in almost two thirds and minimal change disease (MCD) in nearly one quarter of patients. Review of the literature reveals a close temporal relationship between the development of nephrotic syndrome shortly after cessation of immunosuppression and the diagnosis of chronic graft-versushost disease (GVHD). An association of glomerular disease with simultaneous GVHD was seen in 47% of patients overall. Nephrotic syndrome followed GVHD within 5 months in 60% of the combined MCD and MGN reports. A decrease in immunosuppressive medication use was linked to nephrotic syndrome occurrence within 9 months in 63% of patients with MCD and MGN. MCD occurred earlier after hematopoietic cell transplantation, was diagnosed sooner after medication change, and exhibited a better prognosis in comparison with MGN. Glomerular lesions after hematopoietic cell transplantation may therefore represent the renal manifestation of GVHD. Further studies are warranted to delineate the pathogenesis of this complication.

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Section: Analysis Of the Literature And Discussionmentioning

confidence: 99%

Nephrotic Syndrome after Hematopoietic Cell Transplantation

Brukamp¹,

Doyle²,

Bloom³

et al. 2006

Clinical Journal of the American Society of Nephrology

135

134

View full text Add to dashboard Cite

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“…The frequency of NS after BMT has been estimated at about 0.8% [8]. Case reports in the English and Japanese literature between 1988 and 2005 have described variable glomerular histology, comprising mainly MN in almost two-thirds of cases.…”

Section: Discussionmentioning

confidence: 99%

Transplantation-associated thrombotic microangiopathy after steroid pulse therapy for polyserositis related to graft-versus-host disease

et al. 2010

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Transplantation-associated thrombotic microangiopathy (TA-TMA) is a rare but devastating syndrome that occurs in allogeneic hematopoietic stem cell transplant recipients, and is associated with a variety of transplantation-related factors, including conditioning regimens, immunosuppressive agents, graft-versus-host disease (GVHD) and opportunistic infections. TA-TMA has an unfavorable prognosis and responds poorly to conventional treatment including plasma exchange (PE). We present a case of a 37-year-old man with membranous nephropathy (MN) and polyserositis caused by GVHD after hematopoietic stem cell transplantation. He developed TA-TMA after steroid pulse therapy for polyserositis. We treated the patient with PE and mycophenolate mofetil (MMF) after which the TA-TMA successfully improved and the MN underwent complete remission. The present case suggests that corticosteroids with severe GVHD might increase the risk of TA-TMA, and that PE in combination with MMF may be a valuable therapy to improve the prognosis.

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