All issues > Volume 36(11); 1993

Case Report

J Korean Pediatr Soc. 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 HJ Joo¹, Seung Mo SM Park¹, Ran R Namgung¹, Kook In KI Park¹, Jin Sung JS Lee¹, Chul C Lee¹, Dong Kwan DK Han¹, Kir-Young KY Kim¹, Kwang-Hoon KH Lee², Kwang-Gil KG 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

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.

Keywords :Graft-versus-Host Disease, Transfusion, Preterm infant