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| Case report |
| Late-onset unilateral renal dysfunction combined with non-insulin-dependent diabetes mellitus and bronchial asthma following allogeneic bone marrow transplantation for acute lymphoblastic leukemia in a child |
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| M Hirayama1, E Azuma1,a, T Kumamoto1, J Qi1, M Kobayashi1, Y Komada1, T Inui2, M Miyake3, H Mugishima4, M Hamazaki5 and M Sakurai1 |
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1Department of Pediatrics and Clinical Immunology, Mie University, Japan
2Department of Pediatrics, Mie National Hospital, Japan
3Department of Pediatrics, Osaka Medical College, Japan
4Department of Pediatrics, Nihon University, Japan
5Department of Pathology, Shizuoka Children's Hospital, Japan
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aCorrespondence: Dr E Azuma, Department of Clinical Immunology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514, Japan |
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| Abstract |
| We report a child with T cell acute lymphoblastic leukemia who developed late-onset multiple complications after allogeneic bone marrow transplantation from an HLA-matched sibling. The preparative regimen consisted of total body irradiation (TBI, 12 Gy), splenic irradiation (6 Gy) and cytosine arabinoside (3 g/m2 ´ 10). Splenic irradiation was added because of persistent splenomegaly in spite of intensive chemotherapy. He developed bronchial asthma 1½ years post transplant. He presented with microhematuria and proteinuria 4½ years post-transplant, which were due to unilateral left renal dysfunction. He developed type II, non-insulin-dependent diabetes mellitus 8 years post-transplant. A biopsy from the left kidney was not compatible with diabetic nephropathy. All these complications appear to be independently related to BMT, particularly TBI and/or splenic irradiation. |
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| Keywords |
| BMT nephropathy; diabetes mellitus; bronchial asthma |
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| Received 20 January 1998; accepted 23 April 1998 |
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| November 1998, Volume 22, Number 9, Pages 923-926 |
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