中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (6): 1046-1049.doi: 10.3969/j.issn.1673-8225.2012.06.022

• 干细胞综述 stem cell review • 上一篇    下一篇

异基因造血干细胞移植后膜性肾病1例

董秀娟1，周  凯1，焦雪丽1，陈  蕾1，刘萌萌2，韩利杰1，苏  丽3，吴  凡1，赵晓武1   

  1. 郑州市第三人民医院，1血液科，  2病理科，3检验科，河南省郑州市   450000
  • 收稿日期:2011-07-19 修回日期:2011-09-23 出版日期:2012-02-05 发布日期:2012-02-05
  • 通讯作者: 赵晓武，主任医师，郑州市第三人民医院血液科，河南省郑州市 450000 zhaoxiaowu@medmail.com.cn
  • 作者简介:董秀娟，女，1972年生，河南省杞县人，汉族，1994年河南医科大学毕业，副主任医师，主要从事血液系统疾病及造血干细胞移植研究。wudongxiujuan@163.com

Membranous nephropathy after allogeneic hematopoietic stem cells transplantation in one case

Dong Xiu-juan1, Zhou Kai1, Jiao Xue-li1, Chen Lei1, Liu Meng-meng2, Han Li-jie1, Su Li3, Wu Fan1, Zhao Xiao-wu1   

  1. 1Department of Hemotology; 2Department of Pathology; 3Department of Laboratory Medicine, the Third People’s Hospital of Zhengzhou, Zhengzhou  450000, Henan Province, China 
  • Received:2011-07-19 Revised:2011-09-23 Online:2012-02-05 Published:2012-02-05
  • Contact: Zhao Xiao-wu, Chief physician, Department of Hemotology, the Third People’s Hospital of Zhengzhou, Zhengzhou 450000, Henan Province, China zhaoxiaowu@medmail.com.cn
  • About author:Dong Xiu-juan, Associate chief physician, Department of Hemotology, the Third People’s Hospital of Zhengzhou, Zhengzhou 450000, Henan Province, China wudongxiujuan@163.com

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283

被引次数

3

摘要：

背景：移植物抗宿主病的诊断与膜性肾病发病关系密切。
目的：观察异基因造血干细胞移植后肾脏损害的临床特征，以期早期诊断移植物抗宿主病。
方法：回顾性分析1例急性白血病异基因造血干细胞移植后合并膜性肾病患者的临床表现及治疗转归。
结果与结论：患者临床表现为大量蛋白尿、高脂血症、低白蛋白血症等肾病综合征特征，同时眼干、口干等慢性移植物抗宿主病表现加重。肾脏病理诊断为膜性肾病。应用免疫抑制剂如泼尼松、他克莫司及雷公藤等治疗4个月后尿蛋白转阴，临床症状改善。随访3年病情无反复，生活质量好。提示异基因造血干细胞移植后肾脏损害是慢性移植物抗宿主病的一种特殊表现，加强免疫抑制治疗后转归良好，肾脏病理检查对诊断有重要意义。
关键词：膜性肾病；造血干细胞移植；移植物抗宿主病；肾活检；免疫抑制
doi:10.3969/j.issn.1673-8225.2012.06.022

关键词: 膜性肾病, 造血干细胞移植, 移植物抗宿主病, 肾活检, 免疫抑制

Abstract:

BACKGROUND: Graft-versus-host disease (GVHD) in patients is closely related with membranous nephropathy.
OBJECTIVE: To investigate the clinical features of renal damage associated with allogeneic hematopoietic stem cells transplantation (Allo-HSCT) in order to do the early diagnosis of GVHD.
METHODS: A retrospective analysis of clinical presentation and the follow-up therapy and vesting of 1 case of membranous nephropathy after acute leukemia Allo-HSCT.
RESULTS AND CONCLUSION: The clinical manifestations in patient were severe proteinuria, hyperlipidemia, hypoalbuminemia and other features of nephrotic syndrome, and dry eyes, dry mouth and other performance of chronic graft-versus-host disease (cGVHD) was increased. Pathological diagnosis of membranous nephropathy was made. After the treatment of immunosuppressants such as prednisone, tacrolimus and triptolide for 4 months, the proteinuria was negative, clinical symptoms were improved. Up for 3 years without recurrent disease and the life quality was better. Chronic kidney damage is a special performance of cGVHD after Allo-HSCT and the vesting is good with the treatment of immunosuppressive therapy, pathological examination of renal was important for diagnosis.

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