摘要
目的 :探讨异基因骨髓移植后表现在肾脏的慢性移植物抗宿主病 (cGVHD)的临床及病理表现。方法 :通过 1例ABO血型相合、HLA相合的异基因骨髓移植患者cGVHD的临床和病理资料并结合文献复习 ,对其临床和病理形态学的多态性以及治疗的关系进行综合分析。结果 :cGVHD的肾脏累及罕见 ,临床表现为蛋白尿、肾病综合征 ,同时有皮肤、肝脏、口、眼等损害。病理形态学主要为膜性肾病 :肾小球毛细血管袢增厚 ;免疫病理示IgG沿毛细血管袢颗粒状沉积 ;超微病理示肾小球上皮下电子致密物沉积。结论 :异基因骨髓移植后的蛋白尿、肾病综合征可能为自身免疫性疾病 ,是移植物对宿主产生的一种排斥反应。肾穿刺活检对该病的诊断有重要的作用 。
Objective:To investigate the clinicopathological at characteristics of renal chronic graft versus host disease (cGVHD)after allogeneic bone marrow transplantation (BMT).Methods:Clinical and pathological data from a patient with post-BMT cGVHD were analysed with a related references review.Results:The patient developed proteinuria 2 years after allogeneic BMT.Renal biopsy revealed thickening of glomerular basement membrane with granular deposits of IgG along it.Electric microscopy showed electron-dense deposits in subepithelial cells.Conclusion:Nephrotic syndrome or proteinuria after BMT might be an autoimmune disease.Immune suppressor could reduce the incidence of nephrotic syndrome or proteinuria in the BMT patients. Renal biopsy played an important role in the diagnosis and prognosis of renal cGVHD.
出处
《中国中西医结合肾病杂志》
2003年第6期339-341,共3页
Chinese Journal of Integrated Traditional and Western Nephrology
关键词
骨髓移植
术后
膜性肾病
病理
Bone marrow transplantation Allogeneic Chronic Graft versus host disease Membranous nephropathy
