Allogeneic bone marrow transplantation appears to ameliorate IgA nephropathy in a patient with X-linked thrombocytopenia

J Clin Immunol. 2014 Jan;34(1):53-7. doi: 10.1007/s10875-013-9964-4. Epub 2013 Nov 12.

Abstract

Wiskott-Aldrich syndrome (WAS) is caused by a mutation in the WAS gene, and it is clinically characterized by the triad of thrombocytopenia, eczema and immunodeficiency. X-linked thrombocytopenia (XLT), which is a clinically mild form of WAS, is also caused by a WAS gene mutation. Patients with WAS/XLT sometimes also have autoimmune diseases such as IgA nephropathy. Progression of IgA nephropathy may lead to chronic renal failure with a poor prognosis. Here, we describe an XLT patient who also had IgA nephropathy. The patient underwent bone marrow transplantation (BMT) because of an associated-lymphoproliferative disorder, and clinical and histological improvement in his IgA nephropathy was observed after BMT. The amount of galactose-deficient IgA in the patient's serum markedly decreased after BMT. Therefore, immunological reconstitution might improve autoimmune diseases in patients with WAS/XLT.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biopsy
  • Bone Marrow Transplantation*
  • Genetic Diseases, X-Linked / complications*
  • Genetic Diseases, X-Linked / diagnosis
  • Genetic Diseases, X-Linked / therapy*
  • Glomerulonephritis, IGA / complications*
  • Glomerulonephritis, IGA / diagnosis
  • Glomerulonephritis, IGA / therapy*
  • Humans
  • Immunoglobulin A / blood
  • Kidney / pathology
  • Kidney / ultrastructure
  • Male
  • Thrombocytopenia / complications*
  • Thrombocytopenia / diagnosis
  • Thrombocytopenia / therapy*
  • Transplantation, Homologous
  • Treatment Outcome
  • Young Adult

Substances

  • Immunoglobulin A

Supplementary concepts

  • Thrombocytopenia 1