首页> 外文期刊>Endocrine journal >Appearance of thyroid stimulating and blocking immunoglobulins after bone marrow transplantation: presentation of two contrasting cases.
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Appearance of thyroid stimulating and blocking immunoglobulins after bone marrow transplantation: presentation of two contrasting cases.

机译:骨髓移植后甲状腺刺激和阻断免疫球蛋白的出现:两个对比病例。

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摘要

Two acute leukemia cases who presented autoimmune thyroid diseases after bone marrow transplantation (BMT) are described with reference to the pathogenesis of their autoimmune clones. A 37-year old Japanese woman developed Graves' hyperthyroidism 39 months after allogeneic BMT for acute myeloid leukemia (AML) donated from her sister. Although both donor and recipient were euthyroid and negative for thyroid autoimmunity before BMT, the donor was positive for anti-nuclear and anti-single strand DNA autoantibodies. Studies on polymorphism for variable number of tandem repeat region of T-cell receptor gene suggested that the lymphocytes responsible for the hyperthyroidism were of donor origin. The second case was a 12-year-old Japanese schoolboy who presented nongoitrous hypothyroidism 2 years after autologous BMT for acute lymphoblastic leukemia (ALL). He had been clinically euthyroid before transplantation. Family history revealed that his mother and sister had a history of Graves' disease. His serum waspositive for thyroid-stimulation blocking antibody. It is highly likely that the autoimmune process was activated after transient immune suppression during peri-BMT period in this patient. Pathogenesis, incidence, and observed time lag between BMT and development of autoimmune thyroid diseases were discussed.
机译:参照其自身免疫克隆的发病机理,描述了在骨髓移植(BMT)后出现自身免疫性甲状腺疾病的两个急性白血病病例。一位37岁的日本女性在从姐姐捐赠的同种异体BMT治疗急性髓性白血病(AML)后39个月出现了Graves甲状腺功能亢进症。尽管捐献者和接受者均为正常甲状腺,BMT前甲状腺自身免疫为阴性,但捐献者的抗核和单链DNA自身抗体阳性。 T细胞受体基因串联重复序列可变数目的多态性研究表明,负责甲状腺功能亢进症的淋巴细胞是供体来源的。第二例是一名12岁的日本男生,在自体BMT治疗急性淋巴细胞白血病(ALL)后2年出现甲状腺功能减退症。在移植之前,他的临床甲状腺功能正常。家族史显示他的母亲和妹妹有Graves病史。他的血清对甲状腺刺激阻断抗体呈阳性。该患者在BMT周围期间短暂免疫抑制后,很可能激活了自身免疫过程。讨论了发病机理,发病率以及观察到的BMT与自身免疫性甲状腺疾病发展之间的时间差。

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