Related Experiment Videos
Celiac disease transmitted by allogeneic non-T cell-depleted bone marrow transplantation
M J Bargetzi1, A Schönenberger, A Tichelli
1Department of Internal Medicine, Kantonsspital Basel, Switzerland.
Insights
Celiac disease occurred in a patient after a bone marrow transplant from an affected sibling. This case suggests celiac disease can be transmitted via bone marrow transplantation.
Area of Science:
- Immunology
- Gastroenterology
- Hematology
Background:
- Celiac disease is an autoimmune disorder triggered by gluten.
- Allogeneic bone marrow transplantation (BMT) involves replacing diseased bone marrow with healthy stem cells.
- Graft-versus-host disease (GVHD) is a potential complication of allogeneic BMT.
Observation:
- A patient receiving BMT for acute leukemia developed celiac disease symptoms post-transplant.
- The donor was the patient's HLA-identical sister with a history of celiac disease.
Findings:
- The patient exhibited diarrhea, intestinal mucosal atrophy, and celiac-specific antibodies after BMT.
- These findings were absent pre-transplant, and graft-versus-host disease (GVHD) was not present.
Implications:
- This case suggests celiac disease can be transmitted through bone marrow transplantation.
- It supports the role of T cells in the pathogenesis of celiac disease.
Abstract:
We observed the occurrence of celiac disease following allogeneic bone marrow transplantation in a patient transplanted for acute leukemia. The marrow donor was his HLA-identical sister, who had suffered from celiac disease since birth. The post-transplant period was characterized by recurrent episodes of diarrhea. Detailed workup showed atrophic intestinal mucosa on histology and anti-gliadin and anti-endomysium antibodies in the serum, features that were not present before transplantation. GVHD was absent at that time. The patient remains free of symptoms on gluten-free diet and slight immunosuppression. This case suggests transmission of celiac disease by bone marrow transplantation and supports the T cell concept in celiac disease.