Lee W Y, Oh E S, Min C K, Kim D W, Lee J W, Kang M I, Min W S, Cha B Y, Lee K W, Son H Y, Kang S K, Kim C C
Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea.
Bone Marrow Transplant. 2001 Jul;28(1):63-6. doi: 10.1038/sj.bmt.1703102.
Autoimmune diseases can be transmitted and eliminated by bone marrow transplantation (BMT). There have been several cases of autoimmune thyroid disease (AITD) occurring after BMT, but AITD remission has been rarely reported. We present four cases in which the remission or transfer of AITD occurred after an allogeneic BMT. Two patients with severe aplastic anemia (SAA) showed evidence of remission of Hashimoto's thyroiditis which they had before allogeneic BMT. One patient with SAA, which developed during treatment with propylthiouracil for Graves' disease, underwent allogeneic BMT and showed evidence of Graves' disease remission following BMT. In one patient, new AITD occurred after an allogeneic BMT from an HLA-matched sibling who already had AITD. These cases support the evidence that the immune system is newly reconstituted after BMT, and severe autoimmune disease can be an indication for BMT. To fully understand the real changes in autoimmune status after BMT, long-term prospective studies are necessary.
自身免疫性疾病可通过骨髓移植(BMT)进行传播和消除。已有数例骨髓移植后发生自身免疫性甲状腺疾病(AITD)的病例,但AITD缓解的报道很少。我们报告了4例异基因骨髓移植后AITD缓解或转变的病例。两名严重再生障碍性贫血(SAA)患者在异基因骨髓移植前患有桥本甲状腺炎,有缓解的迹象。一名在丙硫氧嘧啶治疗格雷夫斯病期间发生SAA的患者接受了异基因骨髓移植,骨髓移植后显示格雷夫斯病缓解。在一名患者中,来自一名已有AITD的HLA匹配同胞的异基因骨髓移植后出现了新的AITD。这些病例支持了骨髓移植后免疫系统重新构建的证据,严重自身免疫性疾病可能是骨髓移植的指征。为了充分了解骨髓移植后自身免疫状态的真实变化,长期前瞻性研究是必要的。