Spontaneous resolution of transfusion-associated graft-versus-host disease.
BACKGROUND
Transfusion-associated graft-versus-host disease (TA-GVHD) is a serious complication of blood transfusion that is characterized by high fever, a scaly maculopapular erythematous rash, diarrhea, hepatocellular damage with marked elevation of liver function test values, and pancytopenia. It can occur in immunocompetent as well as immunocompromised recipients. The existence of atypical TA-GVHD that resolves spontaneously and does not exhibit all of the manifestations has been suggested, but there has been to date no documented diagnosis of GVHD supported by evidence of engraftment.


METHODS
A female patient presented and was diagnosed with acute myelogenous leukemia (AML:M4), and, after unsuccessful combination chemotherapy, she received a transfusion and developed manifestation of TA-GVHD as well as evidence of chimerism. TA-GVHD was proved by demonstrating Y chromosome-specific genes in the skin by polymerase chain reaction. The manifestations of clinical GVHD abated within 4 months.


CONCLUSIONS
Polymerase chain reaction analysis of Y chromosomes in specimens from female patients is useful in the diagnosis of suspected cases of spontaneously resolving TA-GVHD.
Mori
S
S
Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Matsushita
H
H
Ozaki
K
K
Ishida
A
A
Tokuhira
M
M
Nakajima
H
H
Kizaki
M
M
Sugiura
H
H
Kikuchi
A
A
Handa
M
M
D001483:Base Sequence; D001706:Biopsy; D004247:DNA / Q000032:analysis; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology*; D006801:Humans; D007564:Japan; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008875:Middle Aged; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D012867:Skin / Q000737:chemistry / Q000473:pathology; D065227:Transfusion Reaction; D014998:Y Chromosome
D004247:DNA