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Article: Clinicopathologic analysis of renal biopsies after haematopoietic stem cell transplantation

TitleClinicopathologic analysis of renal biopsies after haematopoietic stem cell transplantation
Authors
KeywordsGraft-versus-host disease
Haematopoietic stem cell transplantation
Renal pathology
Issue Date2008
PublisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/NEP
Citation
Nephrology, 2008, v. 13 n. 4, p. 322-330 How to Cite?
AbstractAim: The ever-growing number and increasing survival of haematopoietic stem cell transplantation (HSCT) allow better recognition of its associated renal injuries. We aimed to study the clinicopathologic features of renal biopsies after HSCT by reviewing 13 percutaneous renal biopsies in our institute (Queen Mary Hospital). Methods: A retrospective clinicopathologic study of all renal biopsies archived to the Department of Pathology, Queen Mary Hospital during the period January 1999 to December 2006 was performed. Biopsies from patients with HSCT were selected. Clinical data on presentation and follow up were retrieved from hospital records and physicians. Results: In the 8-year period, a total of 2233 native renal biopsies were archived. Thirteen renal biopsies were selected from 12 patients with HSCT (11 allogeneic, one autologous). All but one patient were male. The age at renal biopsy ranged from 7 to 63 years (median: 32 years). The median interval of renal biopsy after HSCT was 24 months (range 1-134 months). Evidence of graft-versus-host disease was found in nine patients. The most common presentation was significant proteinuria (10 cases) and renal impairment (eight cases). The predominant histological changes were membranous glomerulonephritis (n = 4) and thrombotic microangiopathy (n = 4). One case of focal segmental glomerulosclerosis, IgA nephropathy, minimal change disease, acute tubular necrosis and hypertensive nephrosclerosis were also recorded. Four of our patients died at 0-11 months after renal biopsy. Of the remaining eight patients with a mean follow up of 43.6 months (range, 10-98 months), chronic renal impairment were found in three (37.5%) patients and significant proteinuria also persisted in three. One patient had cytogenetic evidence of relapse of underlying haematological malignancy after HSCT. Conclusion: Among the various renal lesions after HSCT, membranous glomerulonephritis and thrombotic microangiopathy were the most common. Mechanisms of renal injury varied from graft-versus-host disease-associated immune complex deposition to non-immune complex injury on endothelial cells, glomerular epithelial cells and tubular epithelium. Pathologists and clinicians should attend to the histological and temporal heterogeneity of renal injury when managing patients after HSCT. © 2008 The Authors.
Persistent Identifierhttp://hdl.handle.net/10722/76570
ISSN
2015 Impact Factor: 1.796
2015 SCImago Journal Rankings: 0.894
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, GSWen_HK
dc.contributor.authorLam, MFen_HK
dc.contributor.authorAu, WYen_HK
dc.contributor.authorChim, Sen_HK
dc.contributor.authorTse, KCen_HK
dc.contributor.authorLo, SHKen_HK
dc.contributor.authorFung, SHen_HK
dc.contributor.authorLai, KNen_HK
dc.contributor.authorChan, KWen_HK
dc.date.accessioned2010-09-06T07:22:38Z-
dc.date.available2010-09-06T07:22:38Z-
dc.date.issued2008en_HK
dc.identifier.citationNephrology, 2008, v. 13 n. 4, p. 322-330en_HK
dc.identifier.issn1320-5358en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76570-
dc.description.abstractAim: The ever-growing number and increasing survival of haematopoietic stem cell transplantation (HSCT) allow better recognition of its associated renal injuries. We aimed to study the clinicopathologic features of renal biopsies after HSCT by reviewing 13 percutaneous renal biopsies in our institute (Queen Mary Hospital). Methods: A retrospective clinicopathologic study of all renal biopsies archived to the Department of Pathology, Queen Mary Hospital during the period January 1999 to December 2006 was performed. Biopsies from patients with HSCT were selected. Clinical data on presentation and follow up were retrieved from hospital records and physicians. Results: In the 8-year period, a total of 2233 native renal biopsies were archived. Thirteen renal biopsies were selected from 12 patients with HSCT (11 allogeneic, one autologous). All but one patient were male. The age at renal biopsy ranged from 7 to 63 years (median: 32 years). The median interval of renal biopsy after HSCT was 24 months (range 1-134 months). Evidence of graft-versus-host disease was found in nine patients. The most common presentation was significant proteinuria (10 cases) and renal impairment (eight cases). The predominant histological changes were membranous glomerulonephritis (n = 4) and thrombotic microangiopathy (n = 4). One case of focal segmental glomerulosclerosis, IgA nephropathy, minimal change disease, acute tubular necrosis and hypertensive nephrosclerosis were also recorded. Four of our patients died at 0-11 months after renal biopsy. Of the remaining eight patients with a mean follow up of 43.6 months (range, 10-98 months), chronic renal impairment were found in three (37.5%) patients and significant proteinuria also persisted in three. One patient had cytogenetic evidence of relapse of underlying haematological malignancy after HSCT. Conclusion: Among the various renal lesions after HSCT, membranous glomerulonephritis and thrombotic microangiopathy were the most common. Mechanisms of renal injury varied from graft-versus-host disease-associated immune complex deposition to non-immune complex injury on endothelial cells, glomerular epithelial cells and tubular epithelium. Pathologists and clinicians should attend to the histological and temporal heterogeneity of renal injury when managing patients after HSCT. © 2008 The Authors.en_HK
dc.languageengen_HK
dc.publisherBlackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/NEPen_HK
dc.relation.ispartofNephrologyen_HK
dc.subjectGraft-versus-host diseaseen_HK
dc.subjectHaematopoietic stem cell transplantationen_HK
dc.subjectRenal pathologyen_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshBiopsyen_HK
dc.subject.meshChilden_HK
dc.subject.meshFemaleen_HK
dc.subject.meshGlomerulonephritis, IGA - etiology - pathologyen_HK
dc.subject.meshGlomerulonephritis, Membranous - etiology - pathologyen_HK
dc.subject.meshGlomerulosclerosis, Focal Segmental - etiology - pathologyen_HK
dc.subject.meshGraft vs Host Disease - pathologyen_HK
dc.subject.meshHematopoietic Stem Cell Transplantation - adverse effectsen_HK
dc.subject.meshHong Kongen_HK
dc.subject.meshHumansen_HK
dc.subject.meshKidney - pathologyen_HK
dc.subject.meshKidney Diseases - etiology - mortality - pathologyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshNephrosclerosis - etiology - pathologyen_HK
dc.subject.meshNephrosis, Lipoid - etiology - pathologyen_HK
dc.subject.meshRetrospective Studiesen_HK
dc.subject.meshThrombosis - etiology - pathologyen_HK
dc.subject.meshTime Factorsen_HK
dc.titleClinicopathologic analysis of renal biopsies after haematopoietic stem cell transplantationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1320-5358&volume=13&issue=4&spage=322&epage=330&date=2008&atitle=Clinicopathologic+analysis+of+renal+biopsies+after+haematopoietic+stem+cell+transplantationen_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.emailChan, KW: hrmtckw@hku.hken_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.identifier.authorityChan, KW=rp00330en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1440-1797.2007.00915.xen_HK
dc.identifier.pmid18221254-
dc.identifier.scopuseid_2-s2.0-43449129714en_HK
dc.identifier.hkuros145657en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-43449129714&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume13en_HK
dc.identifier.issue4en_HK
dc.identifier.spage322en_HK
dc.identifier.epage330en_HK
dc.identifier.isiWOS:000256701100009-
dc.publisher.placeAustraliaen_HK
dc.identifier.scopusauthoridChan, GSW=7202355321en_HK
dc.identifier.scopusauthoridLam, MF=35300050600en_HK
dc.identifier.scopusauthoridAu, WY=7202383089en_HK
dc.identifier.scopusauthoridChim, S=6701728225en_HK
dc.identifier.scopusauthoridTse, KC=7102609864en_HK
dc.identifier.scopusauthoridLo, SHK=7401542495en_HK
dc.identifier.scopusauthoridFung, SH=24176513900en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.scopusauthoridChan, KW=16444133100en_HK
dc.identifier.citeulike2798105-

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