Barnabe CCM et al. - The incidence of rheumatic disease development after SCT is unknown, and reported cases may simply reflect those patients who were predisposed to disease development in the first place. However, immunologic manipulation during the SCT process raises the question of whether there is an increased propensity to develop autoimmune disease posttransplant. Clinical vigilance in the recognition of phenotypic changes and clinical events occurring after SCT which may represent new autoimmune phenomena is required.