Condition
Single organ autoimmune disease, including:
Condition
Single organ autoimmune disease, including:
- Coeliac disease (celiac disease, sprue)
- Pernicious anaemia
- Alopecia areata
- Vitiligo
GUIDANCE FOR THYROID DISEASE
Thyroid disease (e.g.Hashimoto throiditis, Graves disease).
Donor must not donate if:
- Malignant (cancerous);
- Any thyroid disorder under investigation
- malignant
- radioactive iodine administered in this pregancy of the preceding six months
- ;
- Graves disease (hyperthyroidism or thyrotoxicosis) within six months of treatment with radioactive iodine therapy;
- Graves disease (hyperthyroidism or thyrotoxicosis) within 2 years of completing anti-thyroid tablet therapy (e.g. carbimazole);
- Currently taking beta-blockers;less than 24 months from stopping treatement with anit-thyroid tablets
GUIDANCE FOR PSORIASIS
Psoriasis is a primarily a skin condition caused by an autoimmune process. About one in ten people with psoriasis may develop join problems (psoriatic arthropathy). Sometimes the disease is treated with powerful drugs to suppress the underlying autoimmune process. This may alter the body's defence mechanism to infection. In such cases the donations should not be taken.
Donor must not donate if:
- has ever taken Etretinate (Tigason)
- less than 24 months from the last dose of Acitretin (Neotigason)
- generalized or server
- associated with arthropathy
- there is a secondary infection
If mild and only topical treatment, accept.
Justification for guidance
Adoptive transfer of these autoimmune diseases has been documented following allogeneic transplant. Because these diseases are not usually life threatening, the recipient and the transplant physician should weigh the risk/benefits of using the specific donor on an individual basis.
References
Aldouri MA, Ruggier R, Epstein O, Prentice HG. Adoptive transfer of hyperthyroidism and autoimmune thyroiditis following allogeneic bone marrow transplantation for chronic myeloid leukaemia. Br J Haematol 1990; 74(1): 118-9.
Berisso GA, van Lint MT, Bacigalupo A, Marmont AM. Adoptive autoimmune hyperthyroidism following allogeneic stem cell transplantation from an HLA-identical sibling with Graves' disease. Bone Marrow Transplant 1999; 23(10): 1091-2.
Campbell-Fontaine A, Coad JE, Kovach R, Ericson SG. Adoptive transfer of vitiligo after allogeneic peripheral blood stem cell transplant. Bone Marrow Transplant 2005; 36(8): 745-6.
Gardembas-Pain M, Ifrah N, Foussard C, Boasson M, Saint Andre JP, Verret JL. Psoriasis after allogeneic bone marrow transplantation. Arch Dermatol 1990; 126(11): 1523.
Holland FJ, McConnon JK, Volpe R, Saunders EF. Concordant Graves' disease after bone marrow transplantation: implications for pathogenesis. J Clin Endocrinol Metab 1991; 72(4): 837-40.
Karthaus M, Gabrysiak T, Brabant G, Prahst A, Link H, Soudah B et al. Immune thyroiditis after transplantation of allogeneic CD34+ selected peripheral blood cells. Bone Marrow Transplant 1997; 20(8): 697-9.
Kishimoto Y, Yamamoto Y, Ito T, Matsumoto N, Ichiyoshi H, Katsurada T et al. Transfer of autoimmune thyroiditis and resolution of palmoplantar pustular psoriasis following allogeneic bone marrow transplantation. Bone Marrow Transplant 1997; 19(10): 1041-3.
Marazuela M, Steegman JL. Transfer of autoimmune hypothyroidism following bone marrow transplantation from a donor with Graves' disease. Bone Marrow Transplant 2000; 26(11): 1217-20.
Olivares JL, Ramos FJ, Olive T, Fillat C, Bueno M. Autoimmune thyroiditis after bone marrow transplantation in a boy with Wiskott-Aldrich syndrome. J Pediatr Hematol Oncol 2002; 24(9): 772-6.
Snowden JA, Heaton DC. Development of psoriasis after syngeneic bone marrow transplant from psoriatic donor: further evidence for adoptive autoimmunity. Br J Dermatol 1997; 137(1): 130-2.
Thomson JA, Wilson RM, Franklin IM. Transmission of thyrotoxicosis of autoimmune type by sibling allogeneic bone marrow transplant. Eur J Endocrinol 1995; 133(5): 564-6.
Waters AH, Metcalfe P, Minchinton RM, Barrett AJ, James DC. Autoimmune thrombocytopenia acquired from allogeneic bone-marrow graft: compensated thrombocytopenia in bone marrow donor and recipient. Lancet 1983; 2(8364): 1430.