Skip to main content

Two cases of transfusion-associated graft-vs-host disease after open heart surgery.

Publication ,  Journal Article
Tanaka, K; Aki, T; Shulman, HM; Sullivan, KM; Tanaka, A; Nagasako, R
Published in: Arch Dermatol
November 1992

BACKGROUND: Some cases of blood transfusion-associated (TA) graft-vs-host disease (GVHD) in immunocompetent patients have been reported, but those dermatologic findings were not precisely mentioned. We describe patients with clinicopathologically TA-GVHD and compare TA-GVHD and acute GVHD after bone marrow transplantation. OBSERVATIONS: Two cases of TA-GVHD after open heart surgery are reported. In both immunocompetent patients, severe erythema multiformelike skin rash developed over the entire body, followed by fever, diarrhea, jaundice, transaminitis, pancytopenia, and marrow alpasia approximately 10 days after operation. The rash in one patient changed from erythema multiformelike to toxic epidermal necrolysis at death. Skin biopsy specimens revealed eosinophilic bodies, basal vacuolation, and exocytosis in the epidermis. Eosinophilic bodies tend to appear in the upper epidermis. Immunohistochemistry studies revealed that infiltrating cells were CD4 and CD8. While acute GVHD in immunosuppressed patients who have undergone bone marrow transplantations often shows lichenoid histologic features, TA-GVHD in our patients who were immunocompetent may resemble severe erythema multiforme or toxic epidermal necrolysis. The difference in TA-GVHD may be related to lack of host modification by immunosuppression. CONCLUSIONS: Irradiation of the blood products should be required in open heart surgery, for TA-GVHD in immunocompetent patients is almost always fatal.

Duke Scholars

Published In

Arch Dermatol

ISSN

0003-987X

Publication Date

November 1992

Volume

128

Issue

11

Start / End Page

1503 / 1506

Location

United States

Related Subject Headings

  • Transfusion Reaction
  • Middle Aged
  • Male
  • Immunocompetence
  • Humans
  • Graft vs Host Disease
  • Female
  • Erythema Multiforme
  • Epidermis
  • Dermatology & Venereal Diseases
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Tanaka, K., Aki, T., Shulman, H. M., Sullivan, K. M., Tanaka, A., & Nagasako, R. (1992). Two cases of transfusion-associated graft-vs-host disease after open heart surgery. Arch Dermatol, 128(11), 1503–1506.
Tanaka, K., T. Aki, H. M. Shulman, K. M. Sullivan, A. Tanaka, and R. Nagasako. “Two cases of transfusion-associated graft-vs-host disease after open heart surgery.Arch Dermatol 128, no. 11 (November 1992): 1503–6.
Tanaka K, Aki T, Shulman HM, Sullivan KM, Tanaka A, Nagasako R. Two cases of transfusion-associated graft-vs-host disease after open heart surgery. Arch Dermatol. 1992 Nov;128(11):1503–6.
Tanaka, K., et al. “Two cases of transfusion-associated graft-vs-host disease after open heart surgery.Arch Dermatol, vol. 128, no. 11, Nov. 1992, pp. 1503–06.
Tanaka K, Aki T, Shulman HM, Sullivan KM, Tanaka A, Nagasako R. Two cases of transfusion-associated graft-vs-host disease after open heart surgery. Arch Dermatol. 1992 Nov;128(11):1503–1506.

Published In

Arch Dermatol

ISSN

0003-987X

Publication Date

November 1992

Volume

128

Issue

11

Start / End Page

1503 / 1506

Location

United States

Related Subject Headings

  • Transfusion Reaction
  • Middle Aged
  • Male
  • Immunocompetence
  • Humans
  • Graft vs Host Disease
  • Female
  • Erythema Multiforme
  • Epidermis
  • Dermatology & Venereal Diseases