J Korean Pediatr Soc.
1993 Nov;36(11):1613-1620.
A case of transfusion-associated graft-versus-host disease in a preterm infant
Abstract
- Graft-versus-host disease is commonly observed after allogeneic bone marrow transplantation but rarely recognized after transfusion of solid-organ transplantation. Tansfusion-associated graftversus-host disease can occur in immunosuppressed recipients and immunocompetent transplant recipients. The clinical manifestations of gastrointestinal or hepatic dysfunction, rash and pancytopenia should heighten the physician's index of suspicion for GVHD. Among premature infants, only four cases have been reported to develop transfusion-associated graft-versus-host disease in the world, with a mortality rate of 100 percent. We recently experienced a preterm male infant who developed acute GVHD (erythematous maculopapular skin rash, hepatic dysfunction and pancytopenia) at two months of age and recovered with Dexamethasone and supportive treatment. A skin biopsy, which performed on the confluent erythematous maculopapular rashes during the active and healing stage of the skin rash, revealed characteristic features of GVHD. Prematurity may be considered as a risk factor for the development of GVHD possibly related to complicated prolonged illnesses which requires intensive care and multiple transfusions. To our knowledge, this is the first report of survival after transfusionassociated graft-versus-host disease in preterm infants.
