| A Case Report of Transfusion Associated Acute Graft - Versus - Host Disease. |
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Jae Hwan Kim, Hyung Mi Kim, Mi Kyoung Lee, Young Chul Park, Suk Min Yoon, Nan Suk Kim, Young Suk Choi |
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Department of Anesthesiology, College of Medicine, Korea University, Seoul, Korea. |
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| Abstract |
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A 46 year old woman was admitted to the Korea University Gynecology department for the resection of a myoma uteri.
Upon admission, preoperative laboratory findings revealed a low hemoglobin level of 8.6 gm/dl, Two units of fresh whole blood donated by her two sons were transfused and her post transfusion hemoglobin was corrected to 10,5 gm/dl. On April 22, she received a transabdominal hysterectomy under general anesthesia during which no significant events occured. Aside from fever and coughing, the postoperative course was uneventful She was discharged seven days after surgery. The patient was readmitted on May 3, with chilling, diarrhea, generalized ache, skin rash, diffuse abdominal pain and tenderness. She was send to ICU, but her condition deteriorated rapidly and her skin rash progressed to generalized erythroderma and icterus was noted. Thereafter she became confused, hypotensive and oligurie. Her blood studies revealed pancytopenia and atypical lymphocytes. The patient was died on May 22, despite all efforts. Although the exact causes of death are still unknown, the presumed diagnosis is acute transfusion associated graft-versus-host disease based on clinical symptoms, signs and laboratory data. |
| Key Words:
Transfusion; Pancytopenia; Graft-versus-host disease |
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