A 46 year old woman was admitted to the Korea University Gynecology department for the resection of a myoma uteri. Upon admission, preperative laboratory findings revealed a low hemoglobin level of 8.6gm/dl. Two units of fresh whole blood donated
by her
two sons were transfused and her post transfusion hemoglobin was corrected to 10.5gm/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 patients was readmitted on May 3, with chilling, diarrhea, generalized ache, skin resh, diffuse abdominal pain and tenderness. She was send to ICU, but her
condition
deteriorated repidly and her skin rash progressed to generalized erythroderma and icterus was noted. Thereafter she became confused, hypotensive and oliguric. 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.
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