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New onset of myasthenia gravis after treatment of systemic sclerosis by autologous hematopoietic stem cell transplantation : sustained autoimmunity or inadequate reset of tolerance?

Deligny, Christophe and Clave, Emmanuel and Sibon, David and Daikeler, Thomas and Keshmandt, Homah and Carmagnat, Maryvonnic and Douay, Corinne and Arfi, Serge and Clair, Bernard and Toubert, Antoine and Farge, Dominique. (2010) New onset of myasthenia gravis after treatment of systemic sclerosis by autologous hematopoietic stem cell transplantation : sustained autoimmunity or inadequate reset of tolerance? Human immunology, Vol. 71, H. 4. pp. 363-365.

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Official URL: http://edoc.unibas.ch/dok/A6003368

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Abstract

Autologous hematopoietic stem-cell transplantation (HSCT) showed promising results for the treatment of primary severe autoimmune diseases (ADs). In this context, development of secondary AD after HSCT has exceptionally been observed, further questioning the roles of patient propensity for AD and of the HSCT procedure. Herein, we report new onset of myasthenia gravis 3 years after successful HSCT in a patient with severe systemic sclerosis, while in complete remission from her first AD. The de novo occurrence of secondary AD (myasthenia gravis) after HSCT was accompanied by the appearance of clonal T-cell expansions measured by the "immunoscope" technique in the context of an ongoing T-cell immune reconstitution. Secondary ADs are increasingly recognized after HSCT for AD. In our case, development of myasthenia followed clonal T-cell expansion. Detailed T-cell repertoire analysis may shed light on autoreactivity mechanisms after HSCT and may help to identify patients at risk.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Rheumatologie FPS (Tyndall)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Rheumatologie FPS (Tyndall)
03 Faculty of Medicine > Departement Biomedizin > Former Units at DBM > Rheumatologie FPS (Tyndall)
UniBasel Contributors:Daikeler, Thomas
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Elsevier
ISSN:0198-8859
Note:Publication type according to Uni Basel Research Database: Journal article
Last Modified:07 Dec 2012 13:03
Deposited On:07 Dec 2012 13:01

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