title: Transmission of lupus anticoagulant by allogeneic stem cell transplantation.
abstract: Passive transmission of autoimmune diseases by allogeneic stem cell transplantation is rare and is ascribed to passive transfer of memory B-cells from donor to recipient. We hereby report a case of transmission of an asymptomatic lupus anticoagulant from a sibling donor to a recipient of transplantation for secondary acute myeloid leukemia. On pre-harvest evaluation, the sibling donor with no history of bleeding or thrombosis was found to have a lupus anticoagulant. After engraftment, the recipient was found to have a new prolonged activated partial thromboplastin time and was subsequently shown to have a lupus anticoagulant on Day +73 after stem cell transplantation. The recipient remained well with no evidence of bleeding, thrombosis, or graft-versus-host disease and was on a stable dose of tacrolimus at the time the lupus anticoagulant was detected. There was no other identifiable trigger for the appearance of a lupus anticoagulant.
authors.affiliation: University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, United States.
authors.forename: Mira Romany
authors.initials: MR
authors.lastname: Massoud
authors.affiliation: University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, United States. Electronic address: bmw93@case.edu.
authors.forename: Basem M
authors.initials: BM
authors.lastname: William
authors.affiliation: University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, United States.
authors.forename: Katrina
authors.initials: K
authors.lastname: Harrill
authors.affiliation: University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, United States.
authors.forename: Brenda Wimpfheimer
authors.initials: BW
authors.lastname: Cooper
authors.affiliation: University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, United States.
authors.forename: Marcos
authors.initials: M
authors.lastname: de Lima
authors.affiliation: University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, United States.
authors.forename: Alvin H
authors.initials: AH
authors.lastname: Schmaier
keywords: Activated partial thromboplastin time; Allogeneic stem cell transplantation; Lupus anticoagulant