Chronic Renal Failure with Severe Mesangiolysis in a Hematopoietic Stem Cell Transplant Recipient

Chronic progressive renal failure is a well-recognized complication in hematopoietic stem cell transplantation (HSCT) recipients. Although thrombotic microangiopathy or chemotherapeutic agents are frequently associated, total body irradiation might also be one of the suspected etiologic factors. This study describes a 38-year-old female patient with acute lymphoblastic leukemia treated with HSCT who developed chronic renal dysfunction after transplantation. Renal biopsy revealed focal and diffuse glomerulosclerosis with extensive mesangiolytic lesions. Her clinical course implied that pretransplant irradiation might have the most impact on the expression of this glomerular lesion.