Membranous Nephropathy as a Manifestation of Graft-Versus-Host Disease: Association With HLA Antigen Typing, Phospholipase A(2) Receptor, and C4d

作者：Byrne Dugan Cathryn J; Collins A Bernard; Lam Albert Q; Batal Ibrahim^*

来源：American Journal of Kidney Diseases, 2014, 64(6): 987-993.

DOI：10.1053/j.ajkd.2014.09.001

• Membranous nephropathy
• glomerulonephritis
• membranous
• hematopoietic stem cell transplantation
• receptor
• phospholipase A(2) (PLA(2)R)
• graft-vs-host disease
• complement C4d
• HLA serological subtypes

Glomerulopathy is an uncommon but increasingly recognized complication of hematopoietic cell transplantation. It typically manifests as membranous nephropathy, less commonly as minimal change disease, and rarely as proliferative glomerulonephritis. There is evidence to suggest that these glomerulopathies might represent manifestations of chronic graft-versus-host disease. In this report, we focus on membranous nephropathy as the most common form of glomerulopathy after hematopoietic cell transplantation. We present a case of membranous nephropathy that developed 483 days post-allogeneic hematopoietic stem cell transplantation in a patient with a history of acute graft-versus-host disease. We also share our experience with 4 other cases of membranous nephropathy occurring after allogeneic hematopoietic stem cell transplantation. Clinicopathologic correlates, including the association with graft-versus-host-disease, HLA antigen typing, glomerular deposition of immunoglobulin G (IgG) subclasses, subepithelial colocalization of IgG deposits with phospholipase A(2) receptor staining, C4d deposition along the peritubular capillaries, and treatment, are discussed with references to the literature.

• 出版日期2014-12