Successful treatment of thrombocytopenia and hemolytic anemia with IvIG in a patient with lupus-like syndrome after mismatched related PBSCT.
Hematopoietic stem cell transplantation (HSCT) is a treatment option for autoimmune diseases but can also cause clinical features similar to those of autoimmune diseases. In some of these cases the autoimmune-like condition is associated with autoimmune cytopenia, a complication that can be unresponsive to established treatment strategies and which may be fatal. The majority of cases reported on immune hemolytic anemia have been of alloimmune origin due to ABO red blood cell antigen incompatibilities between donor and recipient. We now report a patient with a lupus-like syndrome, presenting with severe thrombocytopenia and hemolytic anemia 9 months after HLA-mismatch, ABO compatible-related PBSCT who experienced no response to high-dose steroids, but who had a sustained response to repeated IvIG therapy.
Clinic of Bone Marrow Transplantation and Haematology/Oncology, Idar-Oberstein Germany.
A
A
Hartert
W
W
Willenbacher
S
S
Günzelmann
E
E
Roemer
N
N
Basara
A A
AA
Fauser
M G
MG
Kiehl
D000328:Adult; D000743:Anemia, Hemolytic / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000209:etiology; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006650:Histocompatibility Testing / Q000009:adverse effects; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage; D008177:Lupus Vulgaris / Q000175:diagnosis; D008297:Male; D010976:Platelet Count; D013921:Thrombocytopenia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D014184:Transplantation, Homologous / Q000009:adverse effects*
D016756:Immunoglobulins, Intravenous