Minimal Change Nephrotic Syndrome After Stem Cell Transplantation: a Case Report and Literature Review

Overview

Journal J Med Case Rep

Publisher Biomed Central

Specialty General Medicine

Date 2007 Nov 1

PMID 17971194

Citations 4

Authors

Sandra Silva

Jose Maximino

Rui Henrique

Ana Paiva

Jorge Baldaia

Fernando Campilho

Pedro Pimentel

Alfredo Loureiro

Affiliations

Soon will be listed here.

Abstract

Graft-versus-host disease is one of the most frequent complications occurring after haematopoietic stem cell transplantation. Recently, renal involvement has been described as a manifestation of chronic graft-versus-host disease. Immunosuppression seems to play a major role: clinical disease is triggered by its tapering and resolution is achieved with the resumption of the immunosuppressive therapy. Prognosis is apparently favourable, but long term follow up data are lacking.We report a case of a 53-year-old man who developed nephrotic syndrome 142 days after allogeneic stem cell transplantation for acute myeloid leukaemia. Onset of nephrotic syndrome occurred after reduction of immunosuppressants and was accompanied by manifestations of chronic graft-versus-host disease. Histological examination of the kidney was consistent with Minimal Change Disease. After treatment with prednisolone and mycophenolate mofetil he had complete remission of proteinuria and improvement of graft-versus-host disease. Eighteen months after transplantation the patient keeps haematological remission and normal renal function, without proteinuria.Since patients with chronic graft-versus-host disease might be considered at risk for development of nephrotic syndrome, careful monitoring of renal parameters, namely proteinuria, is advisable.

Citing Articles

Glomerular diseases post-hematopoietic stem cell transplantation: pathologic spectrum and plausible mechanisms.

Caza T, Jhaveri K Clin Kidney J. 2023; 16(6):896-900.

PMID: 37261003 PMC: 10229267. DOI: 10.1093/ckj/sfad023.

Toward a Better Understanding of the Atypical Features of Chronic Graft-Versus-Host Disease: A Report from the 2020 National Institutes of Health Consensus Project Task Force.

Cuvelier G, Schoettler M, Buxbaum N, Pinal-Fernandez I, Schmalzing M, Distler J Transplant Cell Ther. 2022; 28(8):426-445.

PMID: 35662591 PMC: 9557927. DOI: 10.1016/j.jtct.2022.05.038.

Treatment of Concurrent Minimal Change Disease and Epstein Barr Virus-Driven Post-transplant Lymphoproliferative Disorder With Rituximab Following Hematopoietic Stem Cell Transplantation.

Ainley L, Law S, Heptinstall L, Rodriguez-Justo M, Thomson K, Pepper R Kidney Int Rep. 2021; 6(1):224-227.

PMID: 33426402 PMC: 7783564. DOI: 10.1016/j.ekir.2020.10.012.

Albuminuria in hematopoietic cell transplantation patients: prevalence, clinical associations, and impact on survival.

Hingorani S, Seidel K, Lindner A, Aneja T, Schoch G, McDonald G Biol Blood Marrow Transplant. 2008; 14(12):1365-72.

PMID: 19041058 PMC: 2801567. DOI: 10.1016/j.bbmt.2008.09.015.

References

Forslund T, Anttinen J, Hallman H, Heinonen K, Pitkanen R . Mesangial proliferative glomerulonephritis after autologous stem cell transplantation. Am J Kidney Dis. 2006; 48(2):314-20. DOI: 10.1053/j.ajkd.2006.03.085. View

Filipovich A, Weisdorf D, Pavletic S, Socie G, Wingard J, Lee S . National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant. 2005; 11(12):945-56. DOI: 10.1016/j.bbmt.2005.09.004. View

Reddy P, Johnson K, Uberti J, Reynolds C, Silver S, Ayash L . Nephrotic syndrome associated with chronic graft-versus-host disease after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant. 2006; 38(5):351-7. DOI: 10.1038/sj.bmt.1705446. View

Ratanatharathorn V, Ayash L, Lazarus H, Fu J, Uberti J . Chronic graft-versus-host disease: clinical manifestation and therapy. Bone Marrow Transplant. 2001; 28(2):121-9. DOI: 10.1038/sj.bmt.1703111. View

Srinivasan R, Balow J, Sabnis S, Lundqvist A, Igarashi T, Takahashi Y . Nephrotic syndrome: an under-recognised immune-mediated complication of non-myeloablative allogeneic haematopoietic cell transplantation. Br J Haematol. 2005; 131(1):74-9. DOI: 10.1111/j.1365-2141.2005.05728.x. View

Chang A, Hingorani S, Kowalewska J, Flowers M, Aneja T, Smith K . Spectrum of renal pathology in hematopoietic cell transplantation: a series of 20 patients and review of the literature. Clin J Am Soc Nephrol. 2007; 2(5):1014-23. DOI: 10.2215/CJN.01700407. View

Colombo A, Rusconi C, Esposito C, Bernasconi P, Caldera D, Lazzarino M . Nephrotic syndrome after allogeneic hematopoietic stem cell transplantation as a late complication of chronic graft-versus-host disease. Transplantation. 2006; 81(8):1087-92. DOI: 10.1097/01.tp.0000209496.26639.cb. View

Godder K, Pati A, Abhyankar S, Lamb L, Armstrong W, Henslee-Downey P . De novo chronic graft-versus-host disease presenting as hemolytic anemia following partially mismatched related donor bone marrow transplant . Bone Marrow Transplant. 1997; 19(8):813-7. DOI: 10.1038/sj.bmt.1700746. View

Kimura S, Horie A, Hiki Y, Yamamoto C, Suzuki S, Kuroda J . Nephrotic syndrome with crescent formation and massive IgA deposition following allogeneic bone marrow transplantation for natural killer cell leukemia/lymphoma. Blood. 2003; 101(10):4219-21. DOI: 10.1182/blood-2002-07-2290. View

10.

Nouri-Majelan N, Sanadgol H, Ghafari A, Rahimian M, Najafi F, Mortazavizadeh M . Antineutrophil cytoplasmic antibody-associated glomerulonephritis in chronic graft-versus-host disease after allogenic hematopoietic stem cell transplantation. Transplant Proc. 2005; 37(7):3213-5. DOI: 10.1016/j.transproceed.2005.07.031. View

11.

Kemper M, Gungor T, Halter J, Schanz U, Neuhaus T . Favorable long-term outcome of nephrotic syndrome after allogeneic hematopoietic stem cell transplantation. Clin Nephrol. 2007; 67(1):5-11. DOI: 10.5414/cnp67005. View

12.

Socie G . Graft-versus-host disease--from the bench to the bedside?. N Engl J Med. 2005; 353(13):1396-7. DOI: 10.1056/NEJMe058175. View

13.

Seconi J, Watt V, Ritchie D . Nephrotic syndrome following allogeneic stem cell transplantation associated with increased production of TNF-alpha and interferon-gamma by donor T cells. Bone Marrow Transplant. 2003; 32(4):447-50. DOI: 10.1038/sj.bmt.1704151. View

14.

Brukamp K, Doyle A, Bloom R, Bunin N, Tomaszewski J, Cizman B . Nephrotic syndrome after hematopoietic cell transplantation: do glomerular lesions represent renal graft-versus-host disease?. Clin J Am Soc Nephrol. 2007; 1(4):685-94. DOI: 10.2215/CJN.00380705. View

15.

Imai H, Oyama Y, Miura A, Endoh M, Sakai H . Hematopoietic cell transplantation-related nephropathy in Japan. Am J Kidney Dis. 2000; 36(3):474-80. DOI: 10.1053/ajkd.2000.9787. View