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Recurrent nephrotic syndrome associated with graft-versus-host disease

Bone Marrow Transplantation volume 34, pages 1005–1006 (2004)Cite this article

Renal diseases related to hematopoietic stem cell transplantation (HSCT) have been a serious problem. Imai et al1 classified HSCT-related nephropathy into three groups according to the time of onset. Early- or middle-onset nephropathy included acute renal failure and hemolytic uremic syndrome/thrombotic thrombocytopenic purpura. Late-onset nephropathy (over 6 months after HSCT) included nephrotic syndrome (NS), which was predominant, and chronic renal failure. Recently, NS after HSCT has been reported in an association with graft-versus-host disease (GVHD). In most cases, NS shows a good response to immunosuppressive therapy without recurrence. Here, we report the first case of recurrent NS after peripheral blood stem cell transplantation (PBSCT).

A 52-year-old man had general fatigue and was given a diagnosis of Philadelphia-chromosome-positive chronic myeloid leukemia (CML) in August 2000. After interferon therapy did not result in remission, he underwent PBSCT from his HLA-identical sibling at the Department of Hematology in our hospital in May 2001. Conditioning therapy included total body irradiation of 12 Gy, cytarabine of 8 g/m2, and cyclophosphamide of 120 mg/kg. In addition, he received cyclosporine (CYA) at 150 mg/day and short-term methotrexate therapy for the prophylaxis of GVHD. At 1 month after the PBSCT, CYA was withdrawn because of renal insufficiency. Thereafter, acute GVHD appeared as diarrhea, skin pigmentation, and mucosal ulceration. Prednisolone (PSL) at 30 mg/day was administered, and tapered to 10 mg/day after improvement of the symptoms.

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Authors and Affiliations

  1. Second Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan

    R Ikee, K Yamamoto, T Kushiyama, T Imakiire, S Suzuki & S Miura

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  1. R Ikee
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  2. K Yamamoto
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  3. T Kushiyama
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Ikee, R., Yamamoto, K., Kushiyama, T. et al. Recurrent nephrotic syndrome associated with graft-versus-host disease. Bone Marrow Transplant 34, 1005–1006 (2004). https://doi.org/10.1038/sj.bmt.1704703

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