Overlapping Case of Advanced Systemic Sclerosis and IgG4-Related Disease after Autologous Hematopoietic Stem Cell Transplantation
Abstract
1. Introduction
2. Case Presentation
3. Discussion
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Before AHSCT | After AHSCT | |||
---|---|---|---|---|
Date (Time after AHSCT) | 2014 01 | 2014 09 (8 mo.) | 2015 04 (15 mo.) | 2019 04 (63 mo.) |
Hand injury, Raynaud’s syndrome, skin conditions | Advanced sclerodactyly with flexural contractures, osteolysis, deep scarring, cutaneous fibrosis over the whole body, restricted movement | Softer hands and body skin, greater range of movement | Skin induration is reduced all over the body, acral contractures are reduced, wrinkles appear on the face, the amplitude of the yawning increases | Raynaud’s syndrome persistence, mild cutaneous induration; sclerodactyly with flexural contractures, multiple scars, osteolysis of the fingertips (overall positive dynamic) |
DLCO, %, | 67% mild reduction | 61% mild reduction | 63% mild reduction | 73% mild reduction |
Pulmonary function test assessment | FVC 2.6 (81% Ref 3.23), FEV1 1.77 (64% Ref 2.78), FEV1/FVC 68% Ref 81% | FVC 2.71 (84% Ref 3.23), FEV1 1.75 (63% Ref 2.78), FEV1/FVC 65% Ref 81% | FVC 2.6 (81% Ref 3.21), FEV1 1,74 (64% Ref 2.75), FEV1/FVC 67% Ref 81% | FVC 2.39 (77% Ref 3.1), FEV1 1.68 (63% Ref 2.65), FEV1/FVC 70% Ref 80% |
The patient subjectively assessed her condition | Worsening | 50–60% improvement | 90% improvement | 30% improvement |
VAS | 3 | 1 | 1 | 3 |
mRSS | 40 | 34 | 30 | 23 |
HRCT scan (semi-quantitative analysis according to Warrick, 0–30 points) | 14 (GGO, marginal pleural irregularities, intersegmental and subpleural lines) | 13 (slightly less of GGO) | 12 (GGO, pleural thickenings, subpleural lines and solitary subpleural cysts) | 12 |
Capillaroscopy | Abundant avascular zones, isolated giant capillaries, signs of angiogenesis, marked fibrosis | Increased capillary density and isolated haemorrhages are observed as ischaemia and fibrosis decrease | In dynamics, increasing capillary density, decreasing areas of avascular zones, increasing number of giant capillaries | |
Anti-Scl-70 and anti-dsDNR positive | Anti-Scl-70 and anti-dsDNR negative |
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Dulko, A.J.; Butrimiene, I.; Cypiene, A.; Peceliunas, V.; Petroska, D.; Stankeviciene, E.; Rugiene, R. Overlapping Case of Advanced Systemic Sclerosis and IgG4-Related Disease after Autologous Hematopoietic Stem Cell Transplantation. Medicina 2024, 60, 496. https://doi.org/10.3390/medicina60030496
Dulko AJ, Butrimiene I, Cypiene A, Peceliunas V, Petroska D, Stankeviciene E, Rugiene R. Overlapping Case of Advanced Systemic Sclerosis and IgG4-Related Disease after Autologous Hematopoietic Stem Cell Transplantation. Medicina. 2024; 60(3):496. https://doi.org/10.3390/medicina60030496
Chicago/Turabian StyleDulko, Alisa Julija, Irena Butrimiene, Alma Cypiene, Valdas Peceliunas, Donatas Petroska, Ernesta Stankeviciene, and Rita Rugiene. 2024. "Overlapping Case of Advanced Systemic Sclerosis and IgG4-Related Disease after Autologous Hematopoietic Stem Cell Transplantation" Medicina 60, no. 3: 496. https://doi.org/10.3390/medicina60030496
APA StyleDulko, A. J., Butrimiene, I., Cypiene, A., Peceliunas, V., Petroska, D., Stankeviciene, E., & Rugiene, R. (2024). Overlapping Case of Advanced Systemic Sclerosis and IgG4-Related Disease after Autologous Hematopoietic Stem Cell Transplantation. Medicina, 60(3), 496. https://doi.org/10.3390/medicina60030496