Graft-vs.-Host Glomerulopathies



Graft-vs.-Host Glomerulopathies


Anthony Chang, MD










Jones methenamine silver demonstrates thick glomerular basement membrane with sparse silver staining due to the prominent extent of subepithelial immune complex deposition.






IgG demonstrates strong granular to confluent staining of the capillary walls in this hematopoietic cell transplant patient with MGN and GVHD.


TERMINOLOGY


Synonyms



  • Graft-vs.-host disease (GVHD) glomerulopathy


Definitions



  • Glomerular injury in setting of hematopoietic cell transplantation


ETIOLOGY/PATHOGENESIS


Hematopoietic Cell Transplantation (HCT)



  • Mostly allogeneic (80-100%)


  • 3 patterns



    • Membranous glomerulonephritis (MGN)



      • Rare report in autologous HCT


    • Minimal change disease (MCD)


    • Focal segmental glomerulosclerosis


  • Radiation &/or chemotherapy may be contributing factors


Experimental Model



  • Chronic GVHD (parent to F1 bone marrow transplant) in mice leads to MGN due to antibodies to minor MHC antigens

Jul 7, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Graft-vs.-Host Glomerulopathies
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