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NDT Advance Access originally published online on June 8, 2009
Nephrology Dialysis Transplantation 2009 24(9):2946-2949; doi:10.1093/ndt/gfp261
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Fatal nephrotic syndrome complicating allogeneic stem cell transplantation: a case report

Iddo Z. Ben-Dov1, Galina Pizov2, Eldad Ben-Chetrit3, Dvora Rubinger1 and Reuven Or4

1 Nephrology and Hypertension Services 2 Department of Pathology 3 Rheumatology Unit 4 Bone Marrow Transplantation Department, Hadassah–Hebrew University Medical Center, Jerusalem, Israel

Correspondence and offprint requests to: Iddo Ben-Dov; E-mail: iddobe{at}ekmd.huji.ac.il



  Abstract

Disturbed kidney function is a common occurrence after bone-marrow transplantation. Sepsis, nephrotoxic medications, thrombotic microangiopathy and injury related to haemodynamic alterations are frequently accountable. Recently, attention has been given to immune-mediated glomerular damage, related to graft-versus-host disease. Herein we describe the fatal course of a nephrotic syndrome complicating allogeneic stem cell transplantation in a young woman with long-standing paroxysmal nocturnal haemoglobinuria. A post-mortem kidney biopsy revealed amyloidosis of the AA type. Physicians should be aware of the possibility that infections and inflammation accompanying the post-transplantation period may rarely promote the development of systemic amyloidosis or exacerbate silent pre-existing disease.

Keywords: allogeneic stem cell transplantation; amyloidosis A; nephrotic syndrome; paroxysmal nocturnal haemoglobinuria

Received for publication: 29. 4.09
Accepted in revised form: 7. 5.09


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