Graft-versus-host disease of the kidney after rapid tapering of cyclosporin following reduced intensity hematopoietic stem cell transplantation

Ci, Homma; Kami, Masahiro; Masuo, Shigeru; Sakiyama, Michiyo; Kojima, Rie; Hori, Akiko; Kusumi, Eiji; Katori, Hideyuki; Takeuchi, Kengo; Kishi, Yukiko; Murashige, Naoko; Sw, Kim; Takaue, Yoichi; Mitamura, Tadayuki

doi:10.1038/sj.bmt.1704896

Cited by 9 publications

(7 citation statements)

References 12 publications

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“…A finding is consistent with earlier clinical and animal studies [9,10], suggesting that tubules may be targeted in the GVHD. However, our finding showed lower rates of tubulitis compared to previous study reported by El-Seisi et al (12 vs.…”

Section: Discussionsupporting

confidence: 88%

“…CNIs can lead to arteriolar hyalinosis, resulting in glomerular sclerosis [5,6]. Chronic GVHD involving the kidney was reported in several case series [7,8], while it is unclear whether there is an association between acute GVHD and renal damages [9]. Renal impairments are generally not considered a part of acute GVHD; however, in vivo imaging of GVHD in mice showed that several non-classical organs are massively infiltrated by cytotoxic T-cell (CTL) during GVHD, including the brain, the kidneys, and the connective tissues [10].…”

mentioning

confidence: 98%

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Postmortem examination of the kidney in allogeneic hematopoietic stem cell transplantation recipients: possible involvement of graft-versus-host disease

et al. 2008

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To investigate the association between graft-versus-host disease (GVHD) and renal injury after allogeneic stem cell transplantation (allo-SCT), we compared autopsy findings of 26 consecutive allo-SCT recipients with two control groups: patients with hematologic malignancies who received cytotoxic chemotherapy alone (Control 1, n = 21) and those with non-hematologic diseases (Control 2, n = 12). We evaluated the following renal pathology; renal tubulitis, allograft glomerulitis, intimal arteritis, allograft nephropathy, and peritubular capillaritis. These changes were found in 11 allo-SCT recipients and 10 patients in Control 1, but none in Control 2. While overall frequency of renal impairments was similar between allo-SCT recipients and Control 1 (3/26 vs. 1/21), allo-SCT recipients were more likely to have renal tubulitis and peritubular capillaritis compared to Control 1 (5/26 vs. 1/21), but less likely to present with glomerulitis (1/26 vs. 6/21). Grade III-IV acute or extensive-type chronic GVHD were seen in all of the three patients with renal tubulitis and four of the five patients with peritubular capillaritis. Allo-SCT recipients with severe GVHD tended to have tubulitis and peritubular capillaritis. These findings have implications of some renal impairment attributable to GVHD.

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Section: Discussionsupporting

confidence: 88%

mentioning

confidence: 98%

Postmortem examination of the kidney in allogeneic hematopoietic stem cell transplantation recipients: possible involvement of graft-versus-host disease

et al. 2008

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“…Hypothetically all organs should be possible targets for donor T cells; nevertheless, the liver, gastrointestinal tract, skin and lungs 3,5,6 are the principal target organs. 7 Although damage to other organs (for example, kidney) has been described, 8,9 most clinicians do not consider the kidney a target organ for acute GVHD (aGVHD). Several hypotheses have been discussed, but clear alterations of target versus non-target tissues have not been explored yet.…”

Section: Introductionmentioning

confidence: 99%

Early-phase GVHD gene expression profile in target versus non-target tissues: kidney, a possible target?

Sadeghi

Al-Chaqmaqchi

Al-Hashmi

et al. 2012

Bone Marrow Transplant

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“…Nevertheless, case reports and small series have documented ATN, acute interstitial nephritis, and chronic interstitial nephritis in HCT patients (Tables 3 and 4). 30,31,[36][37][38]54,59,71,95 Again, HCT recipients have had a number of exposures potentially injurious to renal tubules including hemodynamic, multiple drugs, infection. 30,31,[36][37][38]54,59,71,95 Again, HCT recipients have had a number of exposures potentially injurious to renal tubules including hemodynamic, multiple drugs, infection.…”

Section: Tubulointerstitial Pathologymentioning

confidence: 99%

“…30,31,[36][37][38]54,59,71,95 Again, HCT recipients have had a number of exposures potentially injurious to renal tubules including hemodynamic, multiple drugs, infection. 35,95,96 One group found association with a history of severe acute or extensive chronic GVHD, 96 whereas the other did not. In 2 cases reports of acute interstitial nephritis in HCT patients with sex mismatched donors and acute interstitial nephritis, molecular or fluorescence in situ hybridization confirmed donor derivation of the infiltrating cells, as expected.…”

Section: Tubulointerstitial Pathologymentioning

confidence: 99%

Renal Pathology Associated With Hematopoietic Stem Cell Transplantation

Troxell

Higgins

Kambham

2014

Advances in Anatomic Pathology

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The kidney is subject to a large variety of injurious factors before, during, and after hematopoietic stem cell transplantation (HCT), leading to a high incidence of acute kidney injury in the peritransplant period. Chronic kidney disease is estimated to impact 15% to 20% of HCT recipients. Although renal biopsies may be deferred in the setting of thrombotic microangiopathy, acute self-limited impairment, or slowly progressive functional decline, in many patients renal biopsy yields important diagnostic insight to guide treatment. Light microscopic, immunofluorescence, and ultrastructural analysis often reveals a number of concurrent abnormalities in glomeruli, tubules, interstitium, and vessels. Meta-analysis of the literature reveals that membranous nephropathy is the most commonly reported glomerular lesion in the setting of HCT, followed by minimal change disease. Autopsy and biopsy studies show that clinical criteria lack sensitivity and specificity for renal acute and chronic thrombotic microangiopathy. Viral infection and other causes of interstitial nephritis and tubular injury are important findings in HCT renal biopsies, which in many instances may not be clinically suspected. Given the complexity and variability of HCT protocols, clinicopathologic correlation is needed.

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Graft-versus-host disease of the kidney after rapid tapering of cyclosporin following reduced intensity hematopoietic stem cell transplantation

Cited by 9 publications

References 12 publications

Postmortem examination of the kidney in allogeneic hematopoietic stem cell transplantation recipients: possible involvement of graft-versus-host disease

Postmortem examination of the kidney in allogeneic hematopoietic stem cell transplantation recipients: possible involvement of graft-versus-host disease

Early-phase GVHD gene expression profile in target versus non-target tissues: kidney, a possible target?

Renal Pathology Associated With Hematopoietic Stem Cell Transplantation

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