Acquisition of vernal and atopic keratoconjunctivitis after bone marrow transplantation.
OBJECTIVE
Vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC) result from genetic and environmental factors. We present patients who had no history of atopic disorders before bone marrow transplantation (BMT) and who seem to have acquired VKC or AKC from their donors, who had atopic disorders.


METHODS
Observational case series.


METHODS
The patients in this study were part of a cohort of patients who had undergone allogeneic hemapoietic stem cell transplantation (HSCT) from January 1997 through December 2007. Of 621 HSCT recipients, four recipients who were free of allergic disorders acquired VKC or AKC from their afflicted donors after HSCT. Each patient underwent complete ophthalmologic examination, determination of the total serum immunoglobulin (Ig) E, and conjunctival scrapings.


RESULTS
Four (0.64%) of 621 patients who had undergone HSCT acquired VKC or AKC after BMT. The donors had VKC or atopic dermatitis. In addition, in two of these four patients, asthma developed. One patient had elevated total serum IgE. Conjunctival scrapings of all four patients revealed the presence of eosinophils. One patient had concurrent graft-versus-host disease.


CONCLUSIONS
VKC and AKC are systemic allergic disorders characterized by local ocular manifestations. This report suggests the possibility of the acquisition of VKC or AKC after BMT by adoptive transfer.
Tabbara
Khalid F
KF
Department of Surgery, Division of Ophthalmology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. k.tabbara@nesma.net.sa
Nassar
Amr
A
Ahmed
Syed Osman
SO
Al Mohareb
Fahad
F
Aljurf
Mahmoud
M
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003228:Conjunctiva / Q000276:immunology; D003233:Conjunctivitis, Allergic / Q000209:etiology* / Q000276:immunology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D016219:Immunotherapy, Adoptive / Q000009:adverse effects; D008297:Male; D014184:Transplantation, Homologous
D007073:Immunoglobulin E