Chronic graft-versus-host disease complicated by membranous glomerulonephritis

Graft-versus-host disease (GVHD) is a major complication of patients who undergo allogeneic haematopoietic stem cell transplantation (alloHSCT). It occurs in 50% of patients with alloHSCT and results from recognition of recipient tissues by the engrafted donor T cells [1]. Whilst clinical manifestations appear within the first few weeks after transplantation in the acute form, the chronic form occurs a few months to a year following transplantation. Many of the features seen in chronic form GVHD (cGVHD) are similar to various immune complex disorders such as collagen vascular diseases. Although murine GVHD has been studied as a model of lupus nephritis [2], in humans glomerulonephritis is rare in bone marrow transplant recipients. Here, we report a patient who was treated with alloHSCT due to chronic myelogenous leukaemia (CML). He subsequently developed nephrotic syndrome following active mucosal cGVHD. In March 1996, a 30-year-old woman was diagnosed as having Philadelphia chromosome (Ph+) CML in chronic phase. Renal functions and liver enzymes were within the normal range.