caa a22 4500 445882573 CHVBK 20180317145548.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1007/s10157-010-0376-y doi (NATIONALLICENCE)springer-10.1007/s10157-010-0376-y Transplantation-associated thrombotic microangiopathy after steroid pulse therapy for polyserositis related to graft-versus-host disease [Elektronische Daten] [Yasunobu Ishikawa, Saori Nishio, Hiroaki Sasaki, Risshi Kudo, Hideki Goto, Masanori Ito, Akira Suzuki, Yuichiro Fukazawa, Toshio Mochizuki, Takao Koike] Transplantation-associated thrombotic microangiopathy (TA-TMA) is a rare but devastating syndrome that occurs in allogeneic hematopoietic stem cell transplant recipients, and is associated with a variety of transplantation-related factors, including conditioning regimens, immunosuppressive agents, graft-versus-host disease (GVHD) and opportunistic infections. TA-TMA has an unfavorable prognosis and responds poorly to conventional treatment including plasma exchange (PE). We present a case of a 37-year-old man with membranous nephropathy (MN) and polyserositis caused by GVHD after hematopoietic stem cell transplantation. He developed TA-TMA after steroid pulse therapy for polyserositis. We treated the patient with PE and mycophenolate mofetil (MMF) after which the TA-TMA successfully improved and the MN underwent complete remission. The present case suggests that corticosteroids with severe GVHD might increase the risk of TA-TMA, and that PE in combination with MMF may be a valuable therapy to improve the prognosis. Japanese Society of Nephrology, 2010 TA-TMA nationallicence Graft-versus-host disease (GVHD) nationallicence Membranous nephropathy (MN) nationallicence Steroid pulse therapy nationallicence Mycophenolate mofetil (MMF) nationallicence Ishikawa Yasunobu Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut Nishio Saori Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut Sasaki Hiroaki Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut Kudo Risshi Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut Goto Hideki Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut Ito Masanori Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut Suzuki Akira Department of Pathology, KKR Sapporo Medical Center, Hiragishi 1-6, Toyohira-ku, 062-0931, Sapporo, Hokkaido, Japan aut Fukazawa Yuichiro Department of Pathology, KKR Sapporo Medical Center, Hiragishi 1-6, Toyohira-ku, 062-0931, Sapporo, Hokkaido, Japan aut Mochizuki Toshio Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut Koike Takao Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut Clinical and Experimental Nephrology Springer Japan 15/1(2011-02-01), 179-183 1342-1751 15:1<179 2011 15 10157 https://doi.org/10.1007/s10157-010-0376-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10157-010-0376-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ishikawa Yasunobu Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Nishio Saori Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Sasaki Hiroaki Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Kudo Risshi Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Goto Hideki Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Ito Masanori Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Suzuki Akira Department of Pathology, KKR Sapporo Medical Center, Hiragishi 1-6, Toyohira-ku, 062-0931, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Fukazawa Yuichiro Department of Pathology, KKR Sapporo Medical Center, Hiragishi 1-6, Toyohira-ku, 062-0931, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Mochizuki Toshio Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 700 1- Koike Takao Department of Medicine II, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, 060-8638, Sapporo, Hokkaido, Japan aut NATIONALLICENCE 773 0- Clinical and Experimental Nephrology Springer Japan 15/1(2011-02-01), 179-183 1342-1751 15:1<179 2011 15 10157 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer