Minimal change disease in graft versus host disease: a podocyte response to the graft?
Minimal change disease in graft versus host disease: a podocyte response to the graft?
复制标题
DOI：
10.5414/cn107420
复制
发表时间：
2013-12-01
影响因子：
1.1
通讯作者：
Johnson, Richard J.
中科院分区：
文献类型：
--
作者：
Huskey, Janna;Rivard, Chris;Johnson, Richard J.
摘要肾病综合征是一种罕见的造血细胞移植并发症。有人认为，肾病综合征可能是移植物抗宿主病的一种有限形式，尽管这两种疾病之间的病理联系尚不清楚。在本文中，我们报告了一例61岁的女性患者，她接受了非清髓性同种异体干细胞移植治疗t细胞前淋巴细胞白血病，随后在停止免疫抑制治疗后不久发展为活检证实的微小变化疾病。尿CD80在活动性疾病期间显著升高，在皮质类固醇诱导缓解后消失。我们假设同种异体供体T细胞靶向肾脏，诱导足细胞表达CD80，导致有限的“移植物抗宿主”病引起蛋白尿。
Nephrotic syndrome is a rare complication of hematopoietic cell transplantation. It has been suggested that nephrotic syndrome may represent a limited form of graft-versus-host disease although the pathological link between these two entities remains unclear. In this paper, we report a case of a 61-year-old female who underwent nonmyeloablative allogenic stem cell transplantation for T-cell prolymphocytic leukemia and subsequently developed biopsy proven minimal change disease shortly after cessation of her immunosuppression therapy. Urinary CD80 was markedly elevated during active disease and disappeared following corticosteroid-induced remission. We hypothesize that alloreactive donor T cells target the kidney and induce podocyte expression of CD80 that results in proteinuria from limited 'graft versus host' disease.