Relapse of Graves’ disease after successful allogeneic bone marrow transplantation
Abstract
As shown in many reports, allogeneic BMT can help cure autoimmune diseases. Conversely, we present a 24-year-old woman with Graves' disease, which was diagnosed just before BMT for CML. The Graves' disease remitted immediately after BMT but relapsed 18 months later. Since the donor was free from thyroid diseases and the patient showed a rapid shift to complete donor chimerism after BMT, the autoimmune problem seemed neither to arise directly from the donor nor simply from the recipient's residual lymphocytes. On the contrary, it was most likely compounded by chronic GVHD as suggested by the accompanying GVHD symptoms and the absolute donor karyotype in bone marrow cells. A Graves' disease-susceptible HLA allele was also shared between recipient and donor, possibly enhancing the chances of this condition developing. Thus, allogeneic BMT may facilitate relapses in autoimmune diseases as well as alleviating them.
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Secondary autoimmunity following allogeneic BMT/HSCT arises by additional mechanisms distinguishing it from other IRTs, including adoptive immunity and graft-versus-host disease with loss of regulation of autoreactive T lymphocytes.
“Secondary autoimmunity following allogeneic BMT/HSCT arises by additional mechanisms distinguishing it from the other IRTs including: (1) adoptive immunity, that is transferral of autoreactive lymphocyte clones from the donor to the recipient and (2) graft-versus-host disease with the loss of regulation of autoreactive T lymphocytes previously kept under control by peripheral immune tolerance [11,”
From 2019 European Thyroid Association Guidelines on the Management of Thyroid Dysfunction following Immune Reconstitution Therapy (2019) · cites this paper as [29]
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Immune reconstitution syndrome and the thyroid
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Muller, I., Moran, C., Lecumberri, B., Decallonne, B., Robertson, N., Jones, J., & Dayan, C. M. (2019) · European Thyroid Journal · doi:10.1159/000500881 · Cited by 78 · see citing works
- Authors
- Hsiao, L.-T., Liu, J.-H., Yen, C.-C., Wang, W.-S., Fan, F., Chiou, T.-J., & Chen, P.-M.
- Affiliations
- Taipei Veterans General Hospital (TW)
- Venue
- Bone Marrow Transplantation
- Published
- 2001-12-01
- Volume
- 28
- Issue
- 12
- Pages
- 1151-1153
- ISSN
- 0268-3369 (ISSN-L)
- 1476-5365
- OpenAlex
- W2081107613
- Cited by
- 20
- References
- 11
- Citations by year
- 2019: 2 · 2018: 1 · 2016: 1 · 2014: 1 · 2013: 3 · 2012: 2
- FWCI
- 0.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Bone Marrow Transplantation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Hematopoietic Stem Cell Transplantation
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Transplantation › Organ and Tissue Transplantation Research
- Keywords
- Graves' disease, relapse, allogeneic bone marrow transplantation, chronic graft-versus-host disease, donor chimerism, HLA matching, chronic myeloid leukemia, autoimmune disease
- MeSH terms
- Adult, Female, Graft vs Host Disease, Graves Disease, HLA Antigens, Humans, Recurrence, Transplantation, Homologous, Autoimmunity, Bone Marrow Transplantation
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