A Chronic Graft-versus-host Disease Case after Improvement of Basedow's Disease developed after Allogeneic Bone Marrow Transplantation

Abstract

 An 11-year-old girl with late relapse of B-cell precursor acute lymphoblastic leukemia of the bone marrow underwent human leukocyte antigen-1 mismatch (7/8 serotypes) allogeneic bone marrow transplantation (BMT) from an unrelated male donor. She developed gradeⅠ acute graft-versus-host disease (GVHD) , but not chronic GVHD. We observed hyperthyroidism 12 months after BMT and detected anti-thyroid stimulating hormone receptor antibody. Furthermore, she was diagnosed with Basedow's disease and treated with thiamazole. Treatment was successful and thyroid function normalized two months after the start of treatment with thiamazole. Additionally, she had a positive Schirmer test 18 months after being diagnosed with Basedow's disease, and treatment was started. However, 29 months after diagnosis of Basedow's disease, she developed ocular symptoms of chronic GVHD although her ocular symptoms had improved. We speculate that the thyroid gland is the target organ of chronic GVHD; therefore, we need to observe carefully other target organs related to chronic GVHD.