J Korean Med Sci.  2003 Apr;18(2):287-289. 10.3346/jkms.2003.18.2.287.

Membranous Nephropathy after Allogeneic Hematopoietic Stem Cell Transplantation in a Patient with Aplastic Anemia: A Case Report

• Kim KW
• Yoon CH
• Kay CS
• Kim HJ
• Suh KS
• Kim SY
• Park SY

• KMID: 2157638
• DOI: http://doi.org/10.3346/jkms.2003.18.2.287

Abstract

Nephrotic syndrome has been described as one of the clinical forms of chronic graft-versus-host disease (cGVHD), but a limited number of cases have been described. We experienced a young female patient with nephrotic syndrome developed 22 months after allogeneic hematopoietic stem cell transplantation (HSCT) for severe aplastic anemia. She had been well after successful management for gut-limited cGVHD until she developed a clinical nephrotic syndrome with hypoalbuminemia of 2.0 g/dL and 24-hr urine protein of 6.88 g/dL. On physical examination and laboratory findings, there was no other evidence of cGVHD. Clinical and renal biopsy findings were consistent with cGVHD-related membranous nephropathy, and immunosuppressive agents with cyclosporine and prednisone were prescribed. After 3 month of treatment, the proteinuria decreased to normal range; and the patient from nephrotic syndrome nearly recovered. We recommend cGVHD-related glomerulonephritis should be considered in all patients with hypoalbuminemia following allogeneic HSCT, even if there is no other evidence of clinical GVHD.

Keyword

Graft vs Host Disease; Nephrotic Syndrome; Glomerulonephritis

MeSH Terms

Adult
Anemia, Aplastic*/physiopathology
Anemia, Aplastic*/therapy
Female
Glomerulonephritis, Membranous/etiology*
Glomerulonephritis, Membranous/pathology
Graft vs Host Disease/physiopathology
Hematopoietic Stem Cell Transplantation/adverse effects*
Human
Kidney Glomerulus/pathology