January 1999, Volume 23, Issue 1, Pages 99 – 101

Case Report

Nephrotic syndrome as a clinical manifestation of graft-versus-host disease (GVHD) in a marrow transplant recipient after cyclosporine withdrawal JSR Oliveira1,4, D Bahia1, M Franco2, C Balda3, S Stella3 & J Kerbauy1 1Department of Hematology, EPM/UNIFESP, São Paulo, Brazil     2Department of Pathology, EPM/UNIFESP, São Paulo, Brazil     3Department of Nephrology, EPM/UNIFESP, São Paulo, Brazil     4Correspondence: JSR Oliveira, Disciplina de Hematologia, Universidade Federal de São Paulo, Escola Paulista de Medicina, Rua Botucatu 740, CEP 04023-900, Brazil

Keywords

nephrotic syndrome;   bone marrow transplant;   GVHD

Abstract

GVHD is one of the most frequent complications of BMT and recently nephrotic syndrome (NS) has been described as a manifestation of chronic GVHD. Here, we present an AA patient who developed NS 1 year after BMT when cyclosporine was stopped. Renal biopsy showed focal sclerosis associated with membranous deposits. He also had other clinical manifestations of chronic GVHD: sicca-like syndrome and colestasis. After 15 days of CsA therapy, he experienced a remarkable improvement in the NS and GVHD as a whole. We comment on immunological mechanisms that could be involved in the pathogenesis of this manifestation.

Received 6 April 1998; Accepted 15 August 1998

^© Macmillan Publishers Ltd 1997