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Myeloablative immunosuppressive treatment with autologous haematopoietic stem cell transplantation in a patient with psoriatic arthropathy and monoclonal gammopathy of undetermined significance
  1. M Mohren,
  2. T Daikeler,
  3. D Benz,
  4. I Günaydin,
  5. L Kanz,
  6. I Kötter
  1. Department of Haematology, Oncology, Immunology and Rheumatology, Tübingen University Hospital, Tübingen, Germany
  1. Correspondence to:
    Dr I Kötter
    Department of Internal Medicine II, Haematology/Oncology, Immunology and Rheumatology, University Hospital, Otfried-Müller-Str 10, 72076 Tübingen, Germany; ina.koettermed.uni-tuebingen.de

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Transplantation of peripheral blood stem cells (PBSCT) is currently explored in patients with refractory autoimmune diseases,1,2 and results so far show that about two thirds of patients who receive a transplant benefit from this procedure.3 Transplant related mortality in patients with autoimmune disease is similar to that seen in patients with non-Hodgkin’s lymphoma.4

CASE REPORT

We report on a 34 year old male patient with a 16 year history of psoriatic arthropathy with mutilating bilateral lesions of the wrists, metacarpal, proximal and distal interphalangeal and metatarsal, and lower extremity interphalangeal joints, who was refractory to treatment with multiple disease modifying, immunosuppressive substances, including gold, methotrexate (MTX), MTX plus sulfasalazine, cyclosporin A (CSA), mycophenolate mofetil (MMF) alone or in combination with CSA, steroids, and a combination of CSA, MTX, and MMF. IgA κ monoclonal gammopathy of unknown significance developed later in the course of …

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