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- Title
Nephrotic syndrome: an under-recognised immune-mediated complication of non-myeloablative allogeneic haematopoietic cell transplantation.
- Authors
Srinivasan, R.; Balow, J. E.; Sabnis, S.; Lundqvist, A.; Igarashi, T.; Takahashi, Y.; Austin, H.; Tisdale, J.; Barrett, J.; Geller, N.; Childs, R.
- Abstract
Nephrotic syndrome (NS) is an extremely rare complication of myeloablative allogeneic haematopoietic cell transplantation (HCT) that usually occurs in association with chronic graft- versus-host disease (C-GVHD). We observed an unexpectedly high incidence of NS in a cohort of 163 consecutive patients undergoing non-myeloablative HCT from a related human leucocyte antigen-compatible donor. Seven patients developed NS at a median 318 d post-transplant (range 119–1203 d; cumulative incidence 6·1%). The median age at onset of NS was 46 years (range 33–59 years); three of the seven patients had no evidence of C-GVHD while four had accompanying limited C-GVHD. At diagnosis, median proteinuria was 16·5 g/24 h (range 3–24 g/24 h). Renal biopsy was performed in four cases and revealed membranous nephropathy. NS was not always associated with other symptoms of C-GVHD, and in contrast to previous reports, usually did not improve with the re-initiation of aggressive immunosuppression, resulting in progressive renal failure necessitating dialysis in three of seven cases. Membranous nephropathy resulting in NS is a previously unrecognised and clinically significant complication of non-myeloablative HCT.
- Subjects
NEPHROTIC syndrome; HEMATOPOIETIC stem cells; STEM cell transplantation; LEUCOCYTES; KIDNEY diseases; SYNDROMES
- Publication
British Journal of Haematology, 2005, Vol 131, Issue 1, p74
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/j.1365-2141.2005.05728.x