一名患有肾病综合征和免疫复合物沉积在肾小管基底膜的造血干细胞移植受者:一例罕见病例报告。

IF 0.8 4区 医学 Q4 UROLOGY & NEPHROLOGY Iranian journal of kidney diseases Pub Date : 2023-09-01
Niloofar Nematollahi, Monir Sadat Hakemi, Farnaz Tavakoli, Fatemeh Nili
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引用次数: 0

摘要

异基因造血干细胞移植(HSCT)后,可能会发生移植物抗宿主病(GVHD),这可能会影响几个器官。尽管HSCT后肾病综合征的存在是罕见的,但有时它发生在GVHD的情况下。GVHD蛋白尿患者肾活检最常见的组织学发现是膜性肾小球肾炎(MGN)。然而,肾小管基底膜(TBM)和肾小球基底膜(GBM)中免疫复合物沉积的报道极为罕见。在此,我们介绍一名65岁的女性,六年前有HSCT病史,因肾病综合征被转诊至德黑兰Shariati医生医院。二次血清学实验室检查均正常。组织病理学研究表明,光镜下弥漫性GBM和TBM增厚、刺突形成、小管间质区炎性单核细胞浸润和急性肾小管损伤。免疫荧光染色显示免疫复合物沉积在GBM、系膜细胞和TBM中。DOI:10.52547/ijkd.7550。
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A Hematopoietic Stem Cell Transplant Recipient with Nephrotic Syndrome and Immune Complex Deposits in Tubular Basement Membrane: A Rare Case Report.

Following allogenic hematopoietic stem cell transplantation (HSCT), graft-versus-host disease (GVHD) may develop which may affect several organs. Although the presence of nephrotic syndrome after HSCT is rare, sometimes it occurs in the setting of GVHD. The most common histological finding on kidney biopsy of patients with proteinuria owing to GVHD is membranous glomerulonephritis (MGN). However, reports of immune complex deposition in the tubular basement membrane (TBM) and glomerular basement membrane (GBM) are extremely rare. Herein we present a 65-year-old female with a history of HSCT at six years ago who was referred to Dr.Shariati Hospital in Tehran with nephrotic syndrome. Secondary serologic laboratory tests were all normal. The histopathologic study indicated diffuse GBM and TBM thickening, spike formation, infiltration of inflammatory mononuclear cells in tubulointerstitial area and acute tubular injury in light microscopy. Immunofluorescence staining showed immune complex deposits in GBM, mesangial cells, and TBM.  DOI: 10.52547/ijkd.7550.

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来源期刊
Iranian journal of kidney diseases
Iranian journal of kidney diseases UROLOGY & NEPHROLOGY-
CiteScore
2.50
自引率
0.00%
发文量
43
审稿时长
6-12 weeks
期刊介绍: The Iranian Journal of Kidney Diseases (IJKD), a peer-reviewed journal in English, is the official publication of the Iranian Society of Nephrology. The aim of the IJKD is the worldwide reflection of the knowledge produced by the scientists and clinicians in nephrology. Published quarterly, the IJKD provides a new platform for advancement of the field. The journal’s objective is to serve as a focal point for debates and exchange of knowledge and experience among researchers in a global context. Original papers, case reports, and invited reviews on all aspects of the kidney diseases, hypertension, dialysis, and transplantation will be covered by the IJKD. Research on the basic science, clinical practice, and socio-economics of renal health are all welcomed by the editors of the journal.
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