Autologous hematopoietic stem cell transplantation in a patient with refractory seropositive myasthenia gravis: A case report

被引:17
作者
Sossa Melo, Claudia Lucia [1 ,2 ]
Maria Pena, Angela [1 ,2 ]
Antonio Salazar, Luis [1 ,2 ]
Ines Jimenez, Sara [1 ,2 ]
David Gomez, Edgar [3 ]
Marcela Chalela, Claudia [1 ]
Ayala-Castillo, Miguel [3 ]
Mauricio Pena, Ivan [4 ,5 ]
机构
[1] Univ Autonoma Bucaramanga, Sch Med, Dept Internal Med, Div Hematol & Hematopoiet Stem Cell Transplantat, Bucaramanga, Colombia
[2] Clin FOSCAL, Hematol & Stem Cell Transplantat Unit, Carrera 24 154-106,Edificio Milton Salazar, Bucaramanga, Colombia
[3] Clin FOSCAL, Dept Internal Med, Bucaramanga, Colombia
[4] Clin FOSCAL, Dept Neurol, Bucaramanga, Colombia
[5] Univ Autonoma Bucaramanga, Sch Med, Dept Internal Med, Div Neurol, Bucaramanga, Colombia
关键词
Miastenia gravis; Refractory; Autologous hematopoietic stem cell transplantation; Treatment; AUTOIMMUNE-DISEASES; MARROW TRANSPLANTATION; MYCOPHENOLATE-MOFETIL; EUROPEAN GROUP; RITUXIMAB; GUIDELINES; BLOOD; TRIAL; SCT;
D O I
10.1016/j.nmd.2018.11.008
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Myasthenia gravis is a neuromuscular autoimmune disease characterized by fatigable weakness of skeletal muscles that results from an antibody-mediated immunological attack directed at acetylcholine postsynaptic receptors. Autologous hematopoietic stem cell transplantation is considered as a treatment option in refractory cases of myasthenia gravis. A 56-year-old Colombian male presented with six months of progressive hoarseness and dysphagia, with a positive repetitive stimulation test suggestive of end plate neuromuscular disease. Myasthenia gravis was confirmed with serology testing that reported presence of circulating acetylcholine postsynaptic receptors antibodies. The patient received several lines of pharmacological treatment and thymectomy without control of symptoms, requiring admission to the intensive care unit and mechanical ventilation in two occasions. Patient underwent autologous hematopoietic stem cell transplantation and has been in complete clinical remission for 65 months. Hematopoietic stem cell transplantation is a well-tolerated treatment that should be considered over conventional therapy in selected patients with refractory myasthenia gravis. (C) 2018 Elsevier B.V. All rights reserved.
引用
收藏
页码:142 / 145
页数:4
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