Mise en rémission par allogreffe de cellules souches hématopoïétiques d’une péri artérite noueuse associée à un syndrome myélodysplasique réfractaire à l’azacytidine

Introduction

Periarteritis nodosa (PAN) is a vasculitis affecting medium-vessel and may be associated with myelodysplastic syndrome. This association needs a simultaneous treatment of the vascular and the hematological disease. However limited data are available on the benefit of hematological treatment, and in particular allogeneic stem cell transplantation, in this situation.

Case report

A 32-year-old patient with refractory periarteritis nodosa and simultaneous myelodysplastic syndrome, was treated with chemotherapy followed by hematopoietic stem cell allograft. The symptoms relating to PAN improved, allowing to decrease the dose of prednisone down to 5 mg/d. However, a hematological relapse occurred two months later leading to the patient's death.

Conclusion

Hematopoietic stem cell allograft may represent a therapeutic option in the management of severe or refractory autoimmune diseases when the hematological indication is retained.