Kidney nontumor / medical renal
Other
Associated with systemic conditions
Bone marrow transplant nephropathy
Author: Nikhil Sangle, M.D.
Last author update: 3 September 2012
Last staff update: 7 August 2023 (update in progress)
Copyright: 2003-2023, PathologyOutlines.com, Inc.
PubMed Search: Bone marrow transplant nephropathy [title]
Table of Contents
Definition / general | Treatment | Case reports | Microscopic (histologic) description | Microscopic (histologic) images | Immunofluorescence description | Electron microscopy description | Differential diagnosisCite this page: Sangle N. Bone marrow transplant nephropathy. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/kidneyBMtransplant.html. Accessed September 30th, 2023.
Definition / general
- May be due to total body irradiation (similar to radiation nephropathy, (eMedicine: Radiation Nephropathy [Accessed 17 January 2018]), although controversial if total body irradiation is risk factor for renal dysfunction (Radiother Oncol 2009;90:242)
- Delayed renal insufficiency (occurs in 20%), hypertension and anemia out of proportion to azotemia; possibly hemolytic uremic syndrome
- May have a long latency period between exposure to radiation and the development of radiation nephritis
- Treatment with angiotensin converting enzyme inhibitor may be useful (Clin Exp Nephrol 2006;10:78)
Treatment
- Supportive therapy
Case reports
- 27 year old man with renal impairment after bone marrow transplant for CML (Arch Pathol Lab Med 2004;128:233)
Microscopic (histologic) description
- Early changes: related to acute tubular necrosis, infection, nephrotoxic drugs, graft versus host disease, tumor lysis syndrome, marrow infusion toxicity, hepatic venoocclusive disease or interstitial nephritis
- Late changes (3 months after bone marrow transplant): prominent mesangiolysis, focal aneurysmal capillary dilation and variable increase in mesangial matrix; also swollen endothelial cells, widened subendothelial space, duplicated (double contour) glomerular basement membrane and focal fibrin thrombi within glomerular capillaries
Microscopic (histologic) images
Images hosted on other servers:
Hypocellular glomerulus, increased mesangial matrix
Immunofluorescence description
- Fibrin, IgM
Electron microscopy description
- Endothelial injury with widened subendothelial space filled with loose, amorphous, granular material (fibrin) and new basement membrane material
- Variable red blood cell fragments
Differential diagnosis
