Abstract: FR-PO765
Diffuse Proliferative Glomerulonephritis After Allogenic Hematopoietic Stem Cell Transplantation: A Rare Manifestation of Chronic Graft vs. Host Disease
Session Information
- Post-Transplantation and Case Reports
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Shen, Lei, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Yang, Jing, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Liu, Shaojun, Huashan Hospital Fudan University, Shanghai, Shanghai, China
Introduction
Renal involvement is rare in chronic graft-versus-host disease (GVHD), of which membranous nephropathy (MN) and minimal change disease (MCD) were the most common renal pathological manifestations. In addition to glomerular diseases, thrombotic microangiopathy and tubulointerstitial diseases had also been detected in this entity.
Case Description
This paper presents a case report of a rare manifestation of chronic graft-versus-host disease (GVHD) in an 18-year-old male patient who underwent hematopoietic stem cell transplantation 3 years ago. This patient was clinically manifested as rapidly progressive glomerulonephritis with various autoantibodies detected in the serum and kidney, which was lupus-like manifestations. The renal pathology of this patient was immune complex-mediated diffuse proliferative glomerulonephritis with partial crescent formation, which was a rare manifestation of chronic GVHD. The patient initially received intensive immunosuppressive therapy and achieved partial remission.
Discussion
Immune-complex mediated diffuse proliferative glomerulonephritis was a rare manifestation of chronic GVHD after HSCT, which response well to immunosuppressive therapy. Our findings suggest that a combination of methylprednisolone pulse and cyclophosphamide followed by mycophenolate mofetil and prednisone was effective in managing the condition. We emphasize the need to consider the possibility of different renal manifestations in GVHD and to give it adequate attention.