Linear IgA dermatosis in an immunosuppressed patient after allogenic bone marrow transplantation

Abstract

Linear IgA dermatosis (LAD) is a well-recognized acquired subepidermal bullous autoimmune disease. LAD is characterized by clinical, histopathological and immunopathological findings. We report the case of a 38-year-old man who suffered from a chronic myeloic leukaemia. Although he received immunosuppressive therapy he developed LAD after an allogenic bone marrow transplantation. After diagnosis of LAD was established we started a successful systemic therapy with dapsone, while continuing the preliminary medication. Here we report for the first time on a possible relationship between LAD and bone marrow transplantation in an immunosuppressed patient.

Basement membrane antibodies in sera of haematopoietic cell recipients are associated with graft‐versus‐host disease

“…7 In addition, a case of BP and a case of linear IgA dermatosis in HCT patients without GvHD were published. 19,20 Here, we demonstrate that circulating antibodies against BMZ proteins are significantly more frequent in GvHD patients (10 ⁄ 42; 24%) than in healthy controls (1 ⁄ 40; 2.5%) or HCT patients without GvHD (0 ⁄ 18; 0%). The most frequently targeted antigen was the BP antigen collagen XVII, which was additionally bound by autoantibodies in 1 ⁄ 11 (9%) psoriasis sera.…”

“…In the past, several cases of bullous immune‐mediated dermatoses, mostly BP, in GvHD patients have been reported 7 . In addition, a case of BP and a case of linear IgA dermatosis in HCT patients without GvHD were published 19,20 …”

Vancomycin‐induced linear IgA bullous dermatosis in an immunosuppressed transplant recipient

“…The number of different antigens observed in LAD may be due to epitope spreading. 5 To our knowledge there are only two cases of idiopathic LAD described in transplant recipients, 6 shows that physicians treating transplant recipients should be aware of this differential diagnosis, as there is a high probability these patients will be exposed to vancomycin. …”

Linear IgA bullous dermatosis following autologous PBSC transplantation in a patient with non-Hodgkin's lymphoma

“…LABD following HSCT is an extremely rare disease, and only one case in which a patient with CML developed the disease after undergoing allogeneic HSCT has been reported. 2 Of note, this patient was well controlled by conventional treatment with topical glucocorticoid and systemic administration of dapsone. Contrary to this report, our patient was resistant to initial treatment with systemic glucocorticoid and dapsone.…”

“…Linear IgA bullous dermatosis (LABD) is one type of AMBD, and clinically resembles bullous pemphigoid, dermatitis herpetiformis, cicatrical pemphigoid and pemphigus vulgaris. [1][2][3] It is histologically characterized by linear deposits of IgA at the basement membrane zone in immunofluorescent studies, and is usually provoked by infections, drugs or malignancies, especially lymphoproliferative disorders. 1,3,4 Here, we describe a patient with non-Hodgkin's lymphoma who developed LABD after autologous HSCT and was successfully treated with glucocorticoid, dapsone and high-dose i.v.…”