title: [A woman complicated with immune thrombocytopenic purpura, subclinical Graves disease and peripheral neuropathy 5 years after allogeneic bone marrow transplantation].
abstract: A 21-year-old woman developed immune thrombocytopenia (ITP), subclinical Graves disease and peripheral neuropathy without typical chronic graft-versus-host disease (GVHD) 5 years following an allogeneic bone marrow transplantation from an HLA-identical sibling. She received high-dose intravenous immunoglobulin (IVIG) and prednisolone (PSL), which resulted in transient recovery of platelet numbers and muscle weakness. A combination of cyclosporine and PSL induced a durable response against not only the thrombocytopenia but also her high levels of thyroid stimulating antibody (TSAb), muscle weakness and sensory abnormality. The level of thyroglobulin in the donor, who had not developed Graves disease, was also elevated, indicating that late onset-subclinical Graves disease was caused by donor lymphocytes that were autoreactive to the thyroid glands.
authors.affiliation: Division of Pediatrics, Matsushita Memorial Hospital.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ishida
authors.forename: Noriko
authors.initials: N
authors.lastname: Shin-Nakai
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Imamura
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yokoi
authors.forename: Takao
authors.initials: T
authors.lastname: Yoshihara
authors.forename: Noriko
authors.initials: N
authors.lastname: Fujii
authors.forename: Kentaro
authors.initials: K
authors.lastname: Tsunamoto
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Hibi
authors.forename: Akira
authors.initials: A
authors.lastname: Morimoto
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Imashuku
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006111:Graves Disease / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008214:Lymphocytes / Q000276:immunology; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy / Q000209:etiology*; D011239:Prednisolone / Q000627:therapeutic use; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy / Q000209:etiology*; D013954:Thyroglobulin / Q000097:blood; D013961:Thyroid Gland / Q000276:immunology; D013997:Time Factors; D014019:Tissue Donors; D014184:Transplantation, Homologous
chemical_list: D016572:Cyclosporine; D013954:Thyroglobulin; D011239:Prednisolone