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A Case of Transfusion-Associated Gragt-Verus-Host Disease in a Preterm Infant

Journal of the Korean Pediatric Society 1993;36(11):1613-1620.
Published online November 15, 1993.
A Case of Transfusion-Associated Gragt-Verus-Host Disease in a Preterm Infant
Hye Jung Joo1, Seung Mo Park1, Ran Namgung1, Kook In Park1, Jin Sung Lee1, Chul Lee1, Dong Kwan Han1, Kir-Young Kim1, Kwang-Hoon Lee2, Kwang-Gil Lee3
1Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea
2Department of Dermatology, College of Medicine, Yonsei University, Seoul, Korea
3Department of Pathology, College of Medicine, Yonsei University, Seoul, Korea
미숙아에서 수혈후 발생한 이식편대숙주질환 1례
주혜정1, 박승모1, 남궁란1, 박국인1, 이진성1, 이철1, 한동관1, 김길영1, 이광훈2, 이광길3
1연세대학교 의과대학 소아과학교실
2연세대학교 의과대학 피부과학교실
3연세대학교 의과대학 병리학교실
Abstract
Graft-versus-host disease is commonly observed after allogeneic bone marrow transplantation but rarely recognized transfusion or solid-organ transplantation. Transfusion-associated graft-versus-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 transfusion-associated graft-versus-host disease in preterm infants.
Key Words: Graft-versus-Host Disease, Transfusion, Preterm infant


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