Minimal change disease in graft versus host disease: a podocyte response to the graft?

Abstract

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.

• Authors: Janna Huskey, Chris Rivard, Han Myint, Scott Lucia, Maxwell Smith, Michiko Shimada, Takuji Ishimoto, Carlos Araya, Eduardo H Garin, Richard J Johnson
• Journal: Clinical nephrology (Clin Nephrol) Vol. 80 Issue 6 Pg. 469-73 (Dec 2013) ISSN: 0301-0430 [Print] Germany
• PMID: 23006339 (Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• B7-1 Antigen

Topics

• B7-1 Antigen (urine)
• Female
• Graft vs Host Disease (etiology)
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Middle Aged
• Nephrosis, Lipoid (etiology)
• Podocytes (immunology)
• Proteinuria (etiology)
• Transplantation, Homologous