case_images: PMC11066190_01
case_images: Flowchart.
case_images: fimmu-15-1366101-g001.jpg
case_images: PMC11066190_01_fimmu-15-1366101-g001.jpg
case_images: f1
case_images: The patient was diagnosed with glucocorticoid-refractory MAS (See Figure 1 for diagnosis and treatment history).
case_images: (A) T cell subsets: T cells decreased to the lowest level within 6 months post-transplantation, during which CMV infection occurred. Subsequently, CD8+ T cells continued to increase, and GvHD developed, while CD4+ T cells remained at a low level after transplantation; (B, C) B cell antigens and immunoglobulins: B cells increased, and immunoglobulins decreased within 1 year after transplantation. Subsequently, B cells decreased while immunoglobulins increased. Both B cells and IgG increased simultaneously after HBV infection; (D) Treatment course: GLB increased first, followed by consecutive increases in ALT/AST and TBil to peak values. After anti-HBV treatment and use of PDN and CsA, GLB/IgG did not decrease significantly, TBil did not go back to normal, and new AIHA occurred. After adding RTX, the above indicators improved significantly.
case_images: fimmu-15-1366101-g002.jpg
case_images: PMC11066190_01_fimmu-15-1366101-g002.jpg
case_images: f2
case_images: At the time of the last follow-up (D 1067), the patient's IgG levels were 25.4 g/L, TBil was 15.7 mmol/L, HGB was 115 g/L, and T cell subsets and B cell antigens had returned to normal levels (see Figures 2A-D).