Adoptive autoimmune hyperthyroidism following allogeneic stem cell transplantation from an HLA-identical sibling with Graves' disease.
Autoimmune diseases which follow allogeneic BMT from a donor who is a patient or a carrier of an autoimmune condition are considered to be a paradigm of adoptive autoimmunity. Seven cases of autoimmune thyroiditis associated with clinical hyperthyroidism have been published to date. In the case reported here a 35-year-old female patient with AML of the M2 subtype received unmanipulated PBSC from her HLA-identical sister who had therapeutically controlled Graves' disease. Antithyroid antibodies, including thyrotropin receptor (TSHR) antibodies, appeared 1 year after transplant. Clinical hyperthyroidism requiring thyrostatic medication appeared after 2 years. The biological and clinical implications of adoptive, post-transplant autoimmunity are briefly discussed.
Berisso
G A
GA
II Division of Haematology and Stem Cell Transplantation Centre, S Martino's Hospital, Genoa, Italy.
van Lint
M T
MT
Bacigalupo
A
A
Marmont
A M
AM
D019264:Adoptive Transfer; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000209:etiology* / Q000276:immunology; D005260:Female; D006111:Graves Disease / Q000276:immunology*; D006680:HLA Antigens; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D006980:Hyperthyroidism / Q000209:etiology* / Q000276:immunology; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D011989:Receptors, Thyrotropin / Q000276:immunology; D014019:Tissue Donors; D014184:Transplantation, Homologous
D001323:Autoantibodies; D006680:HLA Antigens; D011989:Receptors, Thyrotropin