Celiac disease transmitted by allogeneic non-T cell-depleted bone marrow transplantation.
We observed the occurrence of celiac disease following allogeneic bone marrow transplantation in a patient transplanted for acute leukemia. The marrow donor was his HLA-identical sister, who had suffered from celiac disease since birth. The post-transplant period was characterized by recurrent episodes of diarrhea. Detailed workup showed atrophic intestinal mucosa on histology and anti-gliadin and anti-endomysium antibodies in the serum, features that were not present before transplantation. GVHD was absent at that time. The patient remains free of symptoms on gluten-free diet and slight immunosuppression. This case suggests transmission of celiac disease by bone marrow transplantation and supports the T cell concept in celiac disease.
Bargetzi
M J
MJ
Department of Internal Medicine, Kantonsspital Basel, Switzerland.
Schönenberger
A
A
Tichelli
A
A
Fried
R
R
Cathomas
G
G
Signer
E
E
Speck
B
B
Gratwohl
A
A
D000208:Acute Disease; D000293:Adolescent; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002446:Celiac Disease / Q000209:etiology* / Q000276:immunology; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D008212:Lymphocyte Depletion; D008297:Male; D013601:T-Lymphocytes / Q000276:immunology; D014184:Transplantation, Homologous