Fukushima J. Med. Sci., Vol. 56, No. 2, 2010

[Case Report]

A LONG-TERM REMISSION OF RENAL AMYLOIDOSIS WITH NEPHROTIC SYNDROME AFTER AUTOLOGOUS PERIPHERAL BLOOD STEM-CELL TRANSPLANTATION

KAZUEI OGAWA¹⁾, KAZUHIKO IKEDA¹⁾, MIKI FURUKAWA¹⁾, KAYO HARADA-SHIRADO¹⁾, YUMIKO MASHIMO¹⁾, HIROSHI TAKAHASHI¹⁾, HAYATO MATSUMOTO¹⁾, SATOSHI KIMURA¹⁾, AKIKO SHICHISHIMA-NAKAMURA¹⁾, HIROSHI OHKAWARA¹⁾, YUKO HASHIMOTO³⁾, KOICHI ASAHI⁴⁾, HIDEYOSHI NOJI¹⁾, HITOSHI OHTO²⁾ and YASUCHIKA TAKEISHI¹⁾

¹⁾Department of Cardiology and Hematology, Fukushima Medical University, Fukushima, Japan, ²⁾Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan, ³⁾Department of Diagnostic Pathology, Fukushima Medical University, Fukushima, Japan, ⁴⁾Department of Nephrology, Hypertension, Fukushima Medical University, Fukushima, Japan.

(Received September 10, 2010, accepted November 4, 2010)

Abstract: Renal amyloidosis is typically characterized by nephrotic syndrome, often with massive proteinuria and refractory peripheral edema.　We report the case of a patient with renal amyloidosis associated with nephrotic syndrome who maintained remission for 6 years after undergoing high-dose chemotherapy followed by autologous peripheral blood stem-cell transplantation (auto-PBSCT).　The patient was a man aged in his 50s who had developed nephrotic syndrome.　Bone marrow aspiration and kidney biopsy determined that the cause of the nephrotic syndrome was renal amyloidosis due to multiple myeloma, and the patient was admitted to our department in July 2003.　After one course of chemotherapy, auto-PBSCT was performed in March 2004.　Following transplantation, serum M-protein was no longer detectable from March 2005, and the patient achieved complete hematological remission.　Subsequently, proteinuria decreased, serum albumin levels normalized, and nephrotic syndrome improved.　As of 6 years after transplantation, in March 2010, the patient remained in remission, meaning that auto-PBSCT proved extremely effective as a treatment for renal amyloidosis in this case.

Key words: renal amyloidosis, nephrotic syndrome, PBSCT, multiple myeloma

小川一英，池田和彦，古川未希，原田佳代，眞下由美子，高橋裕志，松本勇人，木村　哲，七島晶子，大河原浩，橋本優子，旭　浩一，野地秀義，大戸　斉，竹石恭知

Corresponding author: Kazuei Ogawa, MD, PhD
E-mail address: kogawa@fmu.ac.jp
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