Acquisition and cure of autoimmune disease following allogeneic hematopoietic stem cell transplantation.
Hematopoietic stem cell transplantation (HSCT) can either cause or eliminate autoimmune disease. Here, we report two cases. One was a 33-year-old woman with myelodysplastic syndrome (refractory anemia) who received bone marrow transplantation from her human leukocyte antigen (HLA)-identical sister who had a history of Graves disease. Antithyroid antibodies, including antimicrosomal antibody and antithyroglobulin antibody, appeared 4 months after transplantation. Clinical hyperthyroidism appeared 7 months after transplantation, and a hypothyroid state was noted 2 months later. The other case was a 50-year-old woman with Sjgrens syndrome and hypothyroidism who was diagnosed with peripheral T cell non-Hodgkins lymphoma. She received allogeneic peripheral blood stem cell transplantation (PBSCT) from her histocompatible sister owing to only partial response to traditional chemotherapy. Cure of lymphoma and remission of Sjgrens syndrome was noted 4 years after PBSCT. These two illustrative cases, one of acquisition of hyperthyroidism and the other of remission of Sjgrens syndrome after transplantation, highlights that HSCT can induce adoptive autoimmune disease or cure coincidental autoimmune disease. Donor selection and attentive monitoring is required in such circumstances.
Hou
Hsin-An
HA
Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Tang
Jih-Luh
JL
Hsu
Szu-Chun
SC
Yu
Chia-Li
CL
Chen
Yao-Chang
YC
Yao
Ming
M
D000328:Adult; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000209:etiology* / Q000628:therapy*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D006980:Hyperthyroidism / Q000209:etiology; D007037:Hypothyroidism / Q000209:etiology; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000628:therapy; D013961:Thyroid Gland / Q000276:immunology; D014184:Transplantation, Homologous / Q000009:adverse effects
D001323:Autoantibodies