Spontaneous remission of de novo membranous nephropathy in postallogeneic hematopoietic stem cell transplantation patients: A report of two cases Journal Article

  


Authors: Pak, W. L. W.; Jakubowski, A.; Perales, M. A.; Obrador, C. M. B.; Salvatore, S.; Seshan, S.; Glezerman, I.
Article Title: Spontaneous remission of de novo membranous nephropathy in postallogeneic hematopoietic stem cell transplantation patients: A report of two cases
Abstract: Membranous nephropathy (MN) is one of the most common de novo glomerular diseases developing in patients after allogeneic hematopoietic stem cell transplantation (HSCT). Most authors have used immunosuppression for its treatment to target the underlying immune-mediated processes, akin to graft-versus-host disease, but the optimal management is currently unclear. Limited reports in the literature described the use of a conservative approach with success, particularly in cases with lower risks of progression, such as non-nephroticrange proteinuria or early reduction of proteinuria by 6 months. We report two cases of post-HSCT MN with moderate risk features, namely prolonged durations of nephroticrange proteinuria, that spontaneously resolved with conservative treatment. Patient 1 was of advanced age and in an immunocompromised state, while patient 2 was in need of a greater graft-versus-disease effect from the donor's immune system, which necessitated a balance between the risk of immunosuppression and the risk of progressive kidney function loss. These cases dem onstrated that conservative treatment can be a reasonable approach in selected patients with post-HSCT MN, including those with moderate risk.
Keywords: transplantation; hematopoietic stem cell; bone marrow transplantation; nephrotic syndrome; versus-host-disease; graft-versus-host disease; membranous nephropathy
Journal Title: Clinical Nephrology
Volume: 102
Issue: 6
ISSN: 0301-0430
Publisher: Dustri-Verlag Dr. Karl Feistle  
Date Published: 2024-12-01
Start Page: 370
End Page: 374
Language: English
ACCESSION: WOS:001293646600001
DOI: 10.5414/cn111431
PROVIDER: wos
PUBMED: 39157901
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF. Corresponding MSK author is Ilya Glezerman -- Source: Wos
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MSK Authors
  1. Ilya Gregory Glezerman
    83 Glezerman
  2. Ann Jakubowski
    455 Jakubowski
  3. Miguel-Angel Perales
    913 Perales
  4. Wai Lun Will Pak
    5 Pak
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