CYCLOSPORIN A ASSOCIATED NEPHROTOXICITY IN THE 1ST 100 DAYS AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION - 3 DISTINCT SYNDROMES
CYCLOSPORIN A ASSOCIATED NEPHROTOXICITY IN THE 1ST 100 DAYS AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION - 3 DISTINCT SYNDROMES
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DOI：
10.1111/j.1365-2141.1983.tb02067.x
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发表时间：
1983-01-01
影响因子：
6.5
通讯作者：
NAIDOO, D
中科院分区：
文献类型：
--
作者：
ATKINSON, K;BIGGS, JC;NAIDOO, D
36例患者接受了同种异体（34例）或同基因（2例）骨髓移植治疗重度再生障碍性贫血或急性白血病。19名同种异体受者接受甲氨蝶呤（MTX），15名接受环孢菌素A（CyA）作为主要的免疫抑制剂，以尽量减少移植物与移植后宿主疾病（GVHD）。在第一个100天[天]，移植后肾功能不全的MTX受体比CyA受体谁表现出3种不同的肾毒性综合征少得多，最常见的是，CyA受体无症状氮质血症，蛋白尿，尿管型，受损的尿浓缩能力和高血压。第二，2 CyA受体发生急性可逆性肾功能衰竭沉淀的全身细菌感染，需要透析，其中肾脏是唯一的靶器官：第三，2受体的HLA基因型不相同的移植发展迅速进行性致命的综合征与多器官受累，包括肺，脑和肾，临床和组织学上类似血栓性血小板减少性紫癜。
Thirty-six patients received allogeneic (34) or syngeneic (2) bone marrow transplants as treatment for severe aplastic anemia or acute leukemia. Nineteen of the allogeneic recipients received methotrexate (MTX) and 15 received cyclosporin A (CyA) as the predominant immunosuppressive agent to minimize graft-vs.-host disease (GVHD) post transplant. In the first 100 d [day], post transplant renal dysfunction was much less frequent in the MTX recipients than in the CyA recipients who exhibited 3 distinct syndromes of nephrotoxicity; most commonly, CyA recipients developed asymptomatic azotemia, proteinuria, urinary casts, impaired urinary concentrating ability and hypertension. Secondly, 2 CyA recipients developed acute reversible renal failure precipitated by systemic bacterial infection which required dialysis and in which the kidney was the sole target organ: thirdly, 2 recipients of HLA-genotypically non-identical grafts developed a rapidly progressively fatal syndrome with multiple organ involvement including lung, brain and kidney which clinically and histologically resembled thrombotic thrombocytopenic purpura.