Membranous glomerulopathy in children given allogeneic hematopoietic stem cell transplantation

Graft-versus-host disease (GVHD) is a common complication of allogeneic haematopoietic stem cell transplantation (HSCT), but membranous glomerulopathy (MG) has rarely been described as a manifestation of chronic GVHD. We report 2 cases of MG in children who were given allogeneic HSCT. The clinical findings were characterized by edema of the lower extremities and nephrotic proteinuria in one case; hypertension, haematuria and edema with non-nephrotic proteinuria in the other one. Renal biopsy was consistent with MG and appropriate immunosuppressive therapy was prescribed. Both patients achieved complete remission and are alive without renal disease 4 and 2 years after the diagnosis of MG, respectively. The normal levels of albumin and non-nephrotic proteinuria in one of the 2 cases raise the question of whether the real incidence of MG after HSCT is underestimated. Therefore, we strongly suggest regular urine analysis during the follow up of children given HSCT to timely diagnose MG.