NEPHROTIC SYNDROME IN A BONE-MARROW TRANSPLANT RECIPIENT WITH CHRONICGRAFT-VERSUS-HOST DISEASE

A 21-year-old male developed massive proteinuria and microscopic hemat uria, 1 year after allogeneic BMT for acute lymphoblastic leukemia, Th ese symptoms occurred during an exacerbation of chronic cutaneous graf t-versus-host disease (GVHD). Renal biopsy revealed granular deposits of IgG and IgM along the glomerular basement membrane, and subepitheli al electron dense deposits, A diagnosis of membranous nephropathy was made. With prednisolone therapy proteinuria decreased gradually, and a melioration of cutaneous lesions was also noted. It was speculated tha t the disordered immune regulation of chronic GVHD resulted in the dev elopment of immune complex nephritis.