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Haematology
Minimal change disease following autologous stem cell transplant for Hodgkin lymphoma
  1. Patrick Leung1,
  2. Timothy Pianta2,
  3. David Langsford2,
  4. Hui Sien Tay3 and
  5. Rachel Cooke1
  1. 1Department of Haematology, Northern Health, Epping, Victoria, Australia
  2. 2Department of Nephrology, Northern Health, Epping, Victoria, Australia
  3. 3Department of Anatomical Pathology, Alfred Health, Melbourne, Victoria, Australia
  1. Correspondence to Dr Patrick Leung; patrickshleung{at}gmail.com

Abstract

Nephrotic syndrome is characterised by heavy proteinuria secondary to glomerular injury. It is an uncommon but serious complication of allogeneic haematopoietic stem cell transplant (HSCT), but rarely reported after autologous HSCT. Here, we report the case of a man in his mid-20s who presented with significant peripheral oedema 2 months after autologous HSCT for Hodgkin lymphoma. Investigations demonstrated nephrotic range proteinuria and hypoalbuminaemia. Renal biopsy demonstrated minimal change disease. Initial treatment with glucocorticoids was complicated by toxicity without remission. However, the clinical and biochemical resolution of his nephrotic syndrome promptly followed administration of rituximab. This case highlights nephrotic syndrome as a complication after autologous HSCT and suggests potential effectiveness of rituximab in minimal change disease in the presence of steroid toxicity or other contraindications.

  • Haematology (incl blood transfusion)
  • Nephrotic syndrome

https://doi.org/10.1136/bcr-2023-259306

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    Footnotes

    • Contributors The following authors were responsible for the drafting of the text, sourcing and editing of clinical images and investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: PL, TP, DL, HST and RC. The following authors gave the final approval of the manuscript: PL, TP, DL, HST and RC. The following author is the guarantor: RC.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.