Document Detail

Nonlethal, attenuated, transfusion-associated graft-versus-host disease in an immunocompromised child: case report and review of the literature.
MedLine Citation:
PMID:  20497511     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare complication of transfusion of nonirradiated blood components. It usually affects children in high-risk groups, including those who have primary immunodeficiencies (PIDs). It usually presents with skin, hepatic, digestive, and hematologic involvement and is normally fatal.
CASE REPORT: We report the case of a nonlethal, attenuated, TA-GVHD in a 7-month-old boy. The disease was marked by the presence of a severe rash but lacked all the other usual manifestations. We speculate that the unusually benign course of this disease, which has normally a fulminant course, was due to the fact that this child was under high-dose corticotherapy at the time of the engraftment. This fortunate coincidence led to the survival of this child and allowed the diagnosis of a combined immunodeficiency.
CONCLUSION: A high index of suspicion is required for the diagnosis and proper management of PID. The administration of nonirradiated blood components in the first year of life, sometimes before the clinical suspicion of a PID, is of great concern. TA-GVHD may be more prevalent than reported in the literature and it is possibly a nonidentified cause of death in recipients with unexplained death and nondiagnosed PID.
João F Neves; António Marques; Rosalina Valente; Deolinda Barata
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Transfusion     Volume:  50     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-12-24     Completed Date:  2011-01-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2484-8     Citation Subset:  IM    
Copyright Information:
© 2010 American Association of Blood Banks.
Pediatric Intensive Care Unit, Hospital Dona Estefânia, Lisbon, Portugal.
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MeSH Terms
Adenovirus Infections, Human / complications,  immunology,  therapy*
Blood Transfusion / adverse effects*
Bronchiolitis / complications,  immunology,  therapy
Graft vs Host Disease / etiology,  immunology*
Pneumococcal Infections / complications,  immunology,  therapy*
Sepsis / complications,  immunology,  therapy
Severity of Illness Index

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