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CASE REPORT article

Front. Immunol.
Sec. Alloimmunity and Transplantation
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1464616

Nephrotic syndrome and portal hypertensive ascites after allogeneic hematopoietic stem cell transplantation: a rare manifestation of chronic graft-versus-host disease

Provisionally accepted
SanXi Ai SanXi Ai Yubing Wen Yubing Wen XiaoHong Fan XiaoHong Fan TianRui Hua TianRui Hua Wei Ye Wei Ye XueMei Li XueMei Li Yan Qin Yan Qin *
  • Peking Union Medical College Hospital (CAMS), Beijing, China

The final, formatted version of the article will be published soon.

    Chronic graft-versus-host disease (GVHD) is a major complication after allogeneic hematopoietic stem cell transplantation (HSCT). Chronic GVHD may have atypical manifestations affecting non-classical organs. The diagnosis in patients with atypical manifestations of chronic GVHD is particullarly challenging, and there is a lack of knowledge regarding their pathogenesis and treatment. We reported a case who developed post-HSCT nephrotic syndrome and portal hypertensive ascites, which are both rare and atypical manifestations of chronic GVHD. Kidney biopsy revealed membranous nephropathy and renal thrombotic microangiography with glomerular immune deposits, suggesting antibody-mediated kidney injury. Treatment with ruxolitinib resulted in remission of both nephrotic syndrome and ascites, suggesting a role of cytokines in the pathogenesis. This case highlighted the awareness of nephrotic syndrome and portal hypertensive ascites as atypical manifestations of chronic GVHD, and the efficacy of ruxolitinib for the two manifestations.

    Keywords: chronic GVHD, Membranous nephropathy (MN), Thrombotic microangiopaopathy (TMA), Ruxolitinib, Ascites

    Received: 14 Jul 2024; Accepted: 30 Sep 2024.

    Copyright: © 2024 Ai, Wen, Fan, Hua, Ye, Li and Qin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yan Qin, Peking Union Medical College Hospital (CAMS), Beijing, China

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