“A Known case of myasthenia gravis, psoriasis, alopecia, Sjögren's syndrome, and Multiple Sclerosis (MS) since the age of 14, this 39-year-old female had undergone all available treatments without any desirable outcome. Thus her quality of life had declined significantly,” Dr. Abbas Hajifathali, professor of bone marrow transplant and hematology at Ayatollah Taleghani Hospital in Tehran, told IRNA.
“Specifically, her myasthenia gravis was a refractory one with severe muscle weakness, resulting in repeated respiratory failures that required her to be intubated and mechanical ventilation at the ICU,” he added.
The professor also said that due to persistent failures in treatment and the recurrent crisis of this autoimmune neuromuscular disease, the patient’s muscles had deteriorated and she was suffering from chronic shortness of breath.
Hajifathali further explained: “In addition, her MS has also declined over the past two years. When we met her for the first time, she could hardly walk even with two canes.”
Another member of the transplant team, Dr. Sayeh Parkhideh, faculty member of Shahid Beheshti University of Medical Science, told IRNA that bone marrow transplant had been used successfully to treat various types of blood cancer for more than thirty years in many countries and Iran.
“Actually, besides several risks associated with bone marrow transplant, the treatment is a high-cost one,” she said, adding: “Accordingly, just in the case of failures of all routine treatments, it will be the last procedure to be considered. Consequently, it had not been performed in Iran until then.”
Stressing that this patient suffering from multi autoimmune syndrome was the first case in Iran, Parkhideh noted that they we were not aware of such a case, as the treatment was not performed in Iran until then.
“Enjoying high morale despite many years of chronic diseases, she sent me an email to ask if we could help her promote her quality of life”, Hajfathali said.
Mentioning that the case was undoubtedly a rare one, Parkhideh continued: “In addition to chronic shortness of breath, given the several years of taking immunosuppressive drugs, she was affected with numerous side effects. Therefore, there existed significant life-threatening issues to take into account. However, the transplant team decided to perform such a treatment for the first time in Iran. Spending three months inspecting this demanding multidimensional job, ultimately autologous bone marrow transplant was chosen as the most effective approach to take.”
“While this treatment can be quite helpful for multi autoimmune patients,” she said, “not every patient is a good candidate for this treatment. There are several factors requiring precise deliberation by the transplant team and other relevant specialists. Moreover, the patient’s mental status must be stable enough in the psychiatric assessments.”
Explaining autoimmune diseases, Dr. Mahshid Mehdizadeh, bone marrow transplant specialist and another member of the treatment team, said: “An autoimmune disease is a condition in which the immune system mistakes part of the body like joints or skin as foreign cells just to send out an army of fighter cells to attack them. These types of diseases are chronic, require long time using medications and can negatively affect the patient's quality of life.”
Dr. Mehdizadeh also said: “Some autoimmune diseases, such as myasthenia gravis are rare. Thus, the coexistence of several autoimmune and rare diseases in an individual is somehow unprecedented and worth studying. Therefore, a bone marrow transplant was the sole hope for improving her quality of life and containing the diseases, although she did not have cancer. Now, after a year since her treatment, the general condition of this 39-year-old woman is favorable. With no recurrence of myasthenia gravis and MS attacks, her quality of life has improved significantly.”
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