Journal of the American Society of Nephrology · 2010 · 207 citations · 20 references
MedicineNephrologyPathologyNeoplasiaRenal PathologyStem Cell TransplantationAutoimmune Kidney DiseaseHematopoietic NeoplasmsRenal DiseaseRenal Mass EvaluationRenal NeoplasmsAutologous Stem Cell InfusionAutologous Stem Cell TherapyDirect InjectionLupus Nephritis TherapyNeoplastic ProgressionRenal MalignancyStem Cell-based Therapy
Autologous stem cell transplantation is being explored for lupus nephritis, yet the safety and potential neoplastic risks of different stem cell types remain poorly understood. The study reports a lupus nephritis case treated by direct renal injection of autologous peripheral blood stem cells. The patient developed injection‑site masses and hematuria that were found to be angiomyeloproliferative lesions, suggesting a previously undescribed stem‑cell–derived complication of therapy.
Some reports suggest that autologous hematopoietic stem cell transplantation holds potential for treatment of renal diseases such as lupus nephritis, but the safety of delivering various stem cell types (hematopoietic, mesenchymal, and endothelial precursors) is not well established. Here, we report a case of lupus nephritis treated by direct renal injection of autologous stem cells recovered from peripheral blood. The patient developed masses at the sites of injection and hematuria. We suspected transitional cell carcinoma but nephrectomy revealed that the masses were angiomyeloproliferative lesions. We believe that this previously undescribed pathologic entity is stem cell-derived or -induced. The biologic potential, including the neoplastic potential, of this lesion is unknown. This case illustrates that the development of angiomyeloproliferative lesions is a possible complication of stem cell therapy.
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