Progression of rheumatoid arthritis following bone marrow transplantation. A case report with a 13-year followup.
The progression of rheumatoid arthritis (RA) is documented in a patient receiving a sex-mismatched, allogeneic bone marrow transplant (BMT) for gold-induced marrow aplasia. DNA typing confirmed a high probability of a full donor engraftment (complete chimerism). Although the RA was in complete remission 2 years post-BMT, clinical, laboratory, histologic, and radiologic evidence of the recurrence of synovitis from 3-13 years post-BMT is presented. Implications of these observations for theories of the pathogenesis of RA and the future of immunotherapies are discussed.
McKendry
R J
RJ
Ottawa General Hospital, Ontario, Canada.
Huebsch
L
L
Leclair
B
B
D000741:Anemia, Aplastic / Q000139:chemically induced / Q000628:therapy*; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D016026:Bone Marrow Transplantation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006052:Gold Sodium Thiomalate / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D012008:Recurrence; D012074:Remission Induction; D013997:Time Factors
D018501:Antirheumatic Agents; D006052:Gold Sodium Thiomalate