[A woman complicated with immune thrombocytopenic purpura, subclinical Graves disease and peripheral neuropathy 5 years after allogeneic bone marrow transplantation].
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.
Ishida
Hiroyuki
H
Division of Pediatrics, Matsushita Memorial Hospital.
Shin-Nakai
Noriko
N
Imamura
Toshihiko
T
Yokoi
Kentaro
K
Yoshihara
Takao
T
Fujii
Noriko
N
Tsunamoto
Kentaro
K
Hibi
Shigeyoshi
S
Morimoto
Akira
A
Imashuku
Shinsaku
S
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
D016572:Cyclosporine; D013954:Thyroglobulin; D011239:Prednisolone