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KMID : 0367419930360111613
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Journal of Korean Pediatric Society
1993 Volume.36 No. 11 p.1613 ~ p.1620
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A Case of Transfusion-Associated Graft-Versus-Host Disease in a Preterm Infant
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주혜정
박승모/남궁란/박국인/이진성/이철/한동관/김길영/이광훈
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Abstract
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Graft-versus-host disease is commonly observed after allogeneic bone marrow transplantation but rarely recognized after transfusion of solid-organ transplantation. Tansfusion-associated graftversus-host disease can occur in immunosuppressed
recipients
and immunocompetent transplant recipients. The clinical manifestations of gastrointestinal or hepatic dysfunction, rash and pancytopenia should heighten the physician's index of suspicion for GVHD.
Among premature infants, only four cases have been reported to develop transfusion-associated graft-versus-host disease in the world, with a mortality rate of 100 percent.
We recently experienced a preterm male infant who developed acute GVHD (erythematous maculopapular skin rash, hepatic dysfunction and pancytopenia) at two months of age and recovered with Dexamethasone and supportive treatment. A skin biopsy,
which
performed on the confluent erythematous maculopapular rashes during the active and healing stage of the skin rash, revealed characteristic features of GVHD. Prematurity may be considered as a risk factor for the development of GVHD possibly
related
to
complicated prolonged illnesses which requires intensive care and multiple transfusions. To our knowledge, this is the first report of survival after transfusionassociated graft-versus-host disease in preterm infants.
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KEYWORD
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