Glanzmann's thrombasthenia in two pregnant females

✍ Scribed by Murat Dede; A. Ugur Ural; Mufit Yenen; Zeki Mesten; Iskender Baser

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 311 KB
• Volume: 82
• Category: Article
• ISSN: 0361-8609
• DOI: 10.1002/ajh.20775

✦ Synopsis

after stem cell transplantation (SCT) may manifest as acute renal failure, renal tubular acidosis, and proteinuria [1]. Post-SCT nephrotic syndrome (NS) has histological association with membranous nephropathy. It usually accompanies acute/chronic graft versus host disease (aGVHD/cGVHD) [2], and represents kidney damage mediated by donor lymphocytes. By natural history, GVHD severity usually decreases with time. However, therapeutic induction of GVHD by donor lymphocyte infusion (DLI) may be needed to enhance the graft versus leukemia (GVL) effect. The clinical spectrum of DLI-related GVHD is often different from that after initial SCT [3]. Very little is known about the manifestation, histology, and optimal treatment for DLI related glomerulonephritis [4].

A 27-year-old man with chronic myeloid leukemia (CML) received SCT from an unrelated donor. He was engrafted with grade I aGVHD with no cGVHD. Cyclosporine (CsA) was tailed-off at 1 year. However, molecular and cytogenetic relapse of CML occurred at 36 months. Two doses of DLI (3.5 Â 10 5 lymphocytes/kg) produced complete molecular remission, accompanied Fig. 1. Electron microscopy shows discrete electron-dense deposits in the subepithelial region (original magnification 33,900).