A possible role of low regulatory T cells in anti-acetylcholine receptor antibody positive myasthenia gravis after bone marrow transplantation

BMC Neurology
Masahiko FukatsuYoshikazu Ugawa

Abstract

Chronic graft-versus-host disease (GVHD) appears several months following allogenic hematopoietic stem cell transplantation (HSCT) and is clinically analogous to autoimmune disorder. Polymyositis is a common neuromuscular disorder in chronic GVHD, but myasthenia gravis (MG) is extremely rare. Hence, its pathophysiology and treatment have not been elucidated. A 63-year-old man with a history of chronic GVHD presented with ptosis, dropped head, and dyspnea on exertion, which had worsened over the previous several months. He showed progressive decrement of compound muscle action potential in the deltoid muscle evoked by 3-Hz repetitive nerve stimulation, a positive edrophonium test, and elevated levels of serum anti-acetylcholine receptor antibodies, which suggested a diagnosis of generalized MG. No thymoma was found. Flow cytometric analysis revealed a remarkable depletion of peripheral Tregs (CD4+CD25highFOXP3+ cells, 0.24% of the total lymphocytes). Administration of prednisolone and tacrolimus was insufficient to alleviate his symptoms; however, the use of rituximab successfully improved his condition. Myasthenic symptoms appeared in the process of tapering prednisolone for the treatment of chronic GVHD, supporting the diagnos...Continue Reading

References

Aug 26, 1998·Bone Marrow Transplantation·F BaronY Beguin
Jan 11, 2000·Bone Marrow Transplantation·J E DowellR S Stein
Jun 6, 2007·Bone Marrow Transplantation·F ZajaUNKNOWN GITMO (Gruppo Italiano Trapianto Midollo Osseo)
Jun 21, 2008·Nature Reviews. Immunology·Dario A A VignaliCreg J Workman
May 28, 2009·Blood·Afonso C VigoritoUNKNOWN National Institutes of Health
Dec 18, 2009·Nature Immunology·Kajsa Wing, Shimon Sakaguchi
Mar 13, 2010·Nature Reviews. Immunology·Frances E Lund, Troy D Randall
Dec 21, 2012·Annals of the New York Academy of Sciences·Muthusamy ThiruppathiMatthew N Meriggioli
Dec 21, 2012·Annals of the New York Academy of Sciences·Miriam C SouroujonSara Fuchs
Dec 23, 2014·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Madan H JagasiaMary E D Flowers
Apr 13, 2015·International Journal of Hematology·Muhammad Omer Jamil, Shin Mineishi
Jun 6, 2015·Muscle & Nerve·Katherine M Ruzhansky, Thomas H Brannagan
Jul 27, 2015·Biological Research·Hiroshi TakahashiYasuchika Takeishi
Sep 18, 2015·Lancet Neurology·Nils Erik Gilhus, Jan J Verschuuren
Jul 8, 2016·Annals of Clinical and Translational Neurology·Dustin AndersonZaeem A Siddiqi

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Citations

Sep 10, 2020·Archives of Disease in Childhood. Education and Practice Edition·Bashaer AlbulushiBrahim Tabarki

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