CEN Case Reports

, Volume 3, Issue 1, pp 34–39 | Cite as

An autopsy case that manifested no convincing histological changes of severe renal failure after hematopoietic stem cell transplantation

  • Kosuke Honda
  • Minoru AndoEmail author
  • Masaharu Tsubokura
  • Takuya Yamashita
  • Hideki Akiyama
  • Hisashi Sakamaki
Case Report


A 48-year-old Japanese woman, who had been diagnosed with smoldering adult T-cell leukemia, was admitted to our hospital for hematopoietic stem cell transplantation (HSCT) because of an acute exacerbation of her disease. After myeloablative conditioning procedures, comprising cytarabine with cyclophosphamide and total body irradiation, the HLA-matched unrelated bone marrow stem cells were infused (day 0). Her serum creatinine concentration, having been 0.6 mg/dL at baseline, began to increase from day 1 and was 2.3 mg/L on day 7. Hemodialysis was required to treat fluid overload and worsening uremia on days 8 and 9. On day 10, she presented with refractory hypotension and died due to multi-organ failure on day 12. Renal pathology at autopsy showed no specific histological changes to which her clinically severe acute kidney injury (AKI) was attributable. This case suggests that post-HSCT AKI is not necessarily accompanied by apparent renal histologic damage, even if it is clinically serious.


Acute kidney injury Adult T-cell leukemia Urinary biomarker Cytokine Acute graft-versus-host disease 



We thank Drs. Masaki Hara and Taku Morito at Division of Nephrology for their pertinent comments and practical help with writing this case report.

Conflict of interest

None declared.


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Copyright information

© Japanese Society of Nephrology 2013

Authors and Affiliations

  • Kosuke Honda
    • 1
  • Minoru Ando
    • 1
    Email author
  • Masaharu Tsubokura
    • 2
  • Takuya Yamashita
    • 2
  • Hideki Akiyama
    • 2
  • Hisashi Sakamaki
    • 2
  1. 1.Division of Nephrology, Department of Internal MedicineTokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalTokyoJapan
  2. 2.Division of Hematology, Department of Internal MedicineTokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalTokyoJapan

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