Allogeneic bone marrow transplantation-mediated transfer of specific immunity against Toxocara canis associated with excessive IgE.
A girl with myelodysplastic syndrome (RAEB-T) received HLA-identical bone marrow from her younger brother after myeloablative treatment with busulfan and cyclophosphamide. After bone marrow transplantation, fever, exanthema, pruritus, and a pulmonary infiltrate were treated symptomatically. Bacterial cultures remained negative. Leukocyte engraftment began on day 10, and all blood cell populations proved to be of donor origin on FISH analysis. Increasing IgE levels (21 000 U/ml) on day 14 after BMT, positive RAST, specific IgG-antibodies, and missing Toxocara (T.) canis antigens in the recipient indicated donor-derived seroconversion. Before BMT, the recipient had been negative for T. canis in routine parasitological screening, and the donor proved to be positive for T. canis antibody by ELISA. This report suggests that the transfer of IgE immunity in the absence of detectable antigens may be responsible for IgE-mediated symptoms consistent with toxocara infection and confirms the need for parasite screening in donor medical examinations.
Fischmeister
G
G
St Anna Children's Hospital, Pediatric Stem Cell Transplantation Unit, Kinderspitalgasse 6, A-1090 Vienna, Austria.
Holter
W
W
Matthes-Martin
S
S
Auer
H
H
Emminger-Schmidmeier
W
W
Gadner
H
H
Peters
C
C
D019264:Adoptive Transfer / Q000379:methods; D000818:Animals; D000909:Antibodies, Helminth / Q000096:biosynthesis; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000096:biosynthesis*; D008297:Male; D009190:Myelodysplastic Syndromes / Q000628:therapy; D017166:Toxocara canis / Q000276:immunology* / Q000302:isolation & purification; D014120:Toxocariasis / Q000276:immunology*; D014184:Transplantation, Homologous
D000909:Antibodies, Helminth; D007073:Immunoglobulin E