同種造血幹細胞移植患者に発症するネフローゼ症候群―自験4例から得られた臨床知見―

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タイトル別名
  • Nephrotic syndrome in patients after successful myeloablative allogeneic hematopoietic stem cell transplantation: Clinical findings obtained from four transplanted patients
  • ドウシュ ゾウケツ カンサイボウ イショク カンジャ ニ ハッショウスル ネフローゼ ショウコウグン ジケン 4レイ カラ エラレタ リンショウ チケン
  • Clinical findings obtained from four transplanted patients
  • 自験4例から得られた臨床知見

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We experienced four patients who suffered from nephrotic syndrome after a successful allogeneic hematopoietic stem cell transplantation (HSCT). These cases were seen in the nineteen-year period from September, 1986 to June, 2005. Our data showed that the incidence of nephrotic syndrome was 0.51% (3 out of 585 HSCT patients) in our hospital. Pathological findings of their renal biopsy specimens revealed that 3 patients had membranous nephropathy and that one patient had minimal change disease. Three patients were positive for anti-nuclear antibody. Administration of prednisolone or cyclosporine improved the nephrotic syndrome, leading all patients to a complete or almost complete remission. The nephrotic syndrome occurred at 17 to 25 months after HSCT and accompanied the relapse of chronic graft-versus-host disease (GVHD), possibly due to the termination or a decrease of immunosuppressant administration in all patients. This suggests that immunological abnormality associated with chronic GVHD may be partly involved.

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