Acquisition and cure of autoimmune disease following allogeneic hematopoietic stem cell transplantation.
Acquisition and cure of autoimmune disease following allogeneic hematopoietic stem cell transplantation.
复制标题
异基因造血干细胞移植后自身免疫性疾病的获得和治愈。
DOI：
10.1016/s0929-6646(08)60040-6
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
M. Yao
中科院分区：
文献类型：
--
作者：
H. Hou;Jih;S. Hsu;Chia;Yao;M. Yao
造血干细胞移植（HSCT）可以引起或消除自身免疫性疾病。在这里，我们报告两个案例。1例为33岁骨髓增生异常综合征（难治性贫血）女性患者，接受了其人类白细胞抗原（HLA）相同且有Graves病病史的姐姐的骨髓移植。术后4个月出现抗甲状腺抗体，包括抗微粒体抗体和抗甲状腺球蛋白抗体。移植后7个月出现临床甲状腺功能亢进，2个月后出现甲状腺功能减退。另一例为50岁女性，患有干燥综合征和甲状腺功能减退症，被诊断为外周T细胞非霍奇金淋巴瘤。她接受异基因外周血干细胞移植（PBSCT）从她的组织相容性的妹妹，由于只有部分响应传统的化疗。PBSCT后4年淋巴瘤治愈，干燥综合征缓解。这两个说明性病例，一个是甲状腺功能亢进症的获得，另一个是移植后舍格伦综合征的缓解，强调了HSCT可以诱导过继性自身免疫性疾病或治愈巧合性自身免疫性疾病。在这种情况下，需要选择捐助者并进行认真的监测。
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 antithy-roglobulin 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 Sjögren's syndrome and hypothyroidism who was diagnosed with peripheral T cell non-Hodgkin's 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 Sjögren's syndrome was noted 4 years after PBSCT. These two illustrative cases, one of acquisition of hyperthyroidism and the other of remission of Sjögren's 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.