Change of immunological parameters in the clinical course of a myasthenia gravis patient with chronic graft-versus-host disease.
The change in immunological parameters was studied during the clinical course of a myasthenia gravis (MG) patient with chronic graft-versus-host disease (GVHD), which developed after bone marrow transplantation from an HLA-identical donor. Anti-acetylcholine receptor antibody gradually decreased in the patient treated with immunosuppressive agents, but was not detected in the donor. Lymphocyte numbers were low just before the onset of MG, increased abruptly within several days and then gradually decreased with treatment. The percentage of CD3+ and CD19+ lymphocytes was higher at onset than before, the percentage of CD4+ cells was higher at onset and gradually decreased with treatment, while CD8+ cells showed the lowest level just before onset and gradually increased during the clinical course. CD4+/CD45RA- cells also showed the highest levels at onset and a gradual decrease with treatment. Cellular, as well as humoral immune responses, might be associated with the pathogenesis of MG with chronic GVHD.
Hayashi
M
M
Department of Pediatrics, Ehime University School of Medicine, Japan.
Matsuda
O
O
Ishida
Y
Y
Kida
K
K
D002648:Child; D002908:Chronic Disease; D006086:Graft vs Host Disease / Q000150:complications*; D006801:Humans; D016131:Lymphocyte Subsets; D008297:Male; D009157:Myasthenia Gravis / Q000209:etiology / Q000276:immunology*