Introduction: In connection with usage of allogeneic bone marrow transplantations (BMT) there rises the problem of transfer of lymphocytes capable of induction autoimmunological reactions in recipient.
The aim of our study: Is a presentation of ultrastructural changes in thyroid tissue as the pathogenesis of autoimmunological thyroid disease in a recipient following BMT from donor with Graves disease after total surgical treatment.
Material and methods: The thyroid gland tissue removed during surgery was routinely fixed and stained with hematoxylin and eosin. The immunohistochemical investigation of lymphocyte subsets was performed using DAKO monoclonal antibodies. Fluorescence in situ hybridization studies (FISH) was performed using a commercially available CEP X/Y DNA Probe (Vysis). Histological specimens were routine estimated and investigated in electron microscope.
Case report: The 14 -year boy who underwent bone marrow transplantation (BMT) for severe aplastic anemia from his HLA matched sister, who had been diagnosed with Graves disease 5 years before transplantation. After 2 years of BMT, the same disease was diagnosed in the recipient. Thyreoidectomy was performed after achieving a euthyroid state. The thyroid gland contained interstitial lymphocytic infiltrates: T, B and antigen presenting cells. FISH showed that at least some of the lymphocytes were of donor origin and these could be seen among the recipients thyroid cells. In the ultrastructural investigations were noticed numerous lymphocytes such as plasmocytes between thyroid cells in contact with thyrocytes. It was observed the lymphocytes in contact with plasmocytes and the lymphoblasts and lymphocytes in lymphatic follicules. The thyrocytes were very active and in numerous places were proliferated.
Conclusions: In thyroid were ultrastructural changes typical for AITD observed. The transfer of donor immunocompetent cells to the recipient of hematopoetic stem cells has been proposed as a mechanism of inducing autoimmune thyroiditis post BMT.
Grant 2P05E04327 Min. Science and Inform. Poland