AUTHOR=Liu Xudong , Zhu Wenxiang , Su Nan , Ma Yanyi , Wang Fang , Xu Jingyi , Zhang Heyang , Luo Xiaomeng , Zhao Yuetong , Wang Jianxun , Shi Yuanyuan , Li Yishuo , Yang Pingting TITLE=Case Report: Remission of a patient with complex combination of autoimmune diseases by anti-CD19 CAR-T cell therapy JOURNAL=Frontiers in Immunology VOLUME=Volume 16 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2025.1645304 DOI=10.3389/fimmu.2025.1645304 ISSN=1664-3224 ABSTRACT=CAR−T cell therapy has been proven effective in various autoimmune diseases, with most studies utilizing lentiviral‐transduced CAR−T cells. In recent years, retroviral vector−transduced CAR−T cells—characterized by a high positivity rate, stable cell lines, and lower plasmid requirements—have attracted increasing attention. This article presents a complex case of a patient with SLE combined with APS and TBIRS. For four years following the diagnosis, the patient underwent conventional steroid therapy and immunotherapy, which yielded unsatisfactory and relapse−prone results. After receiving anti−CD19 CAR−T cells transduced with a retroviral vector, the patient experienced an excellent postoperative recovery without any infusion−related adverse reactions. Post−treatment, the patient’s creatinine, anti-dsDNA antibodies, albumin, and glycated hemoglobin levels returned to normal, eliminating the need for ongoing glucocorticoids or hypoglycemic agents. Although there are some available reports of CAR-T cells treating SLE, it is still very rare and significant for successfully treating such a complicated case, especially after proving the unavailability of traditional therapy. Furthermore, this is the first reported case of treating TBIRS syndrome with retroviral vector−transduced CAR−T therapy.