Mineta H, Sakai T, Suzuki I, Kunimoto M, Satou M, Yasuhara A, Ishizaki H, Morita H, Nozue M
Department of Otolaryngology, Hamamatsu University School of Medicine.
Nihon Jibiinkoka Gakkai Kaiho. 1992 Jun;95(6):891-7. doi: 10.3950/jibiinkoka.95.891.
We report a case of fatal transfusion-associated graft versus host disease (GVHD) that developed in a patient with laryngeal cancer. After a 39.6Gy irradiation dose, total laryngectomy with right radical neck dissection was performed. The postoperative course was uneventful. However, seven days after blood transfusion, high fever (38.5 degrees C) suddenly appeared. On the ninth day, watery diarrhea and facial erythema were observed. On the 12th day, liver disturbance and pancytopenia developed. The patient died on the 16th day because of overwhelming sepsis. Transfusion-associated GVHD has a mortality rate of more than 90%. Therefore, the most important procedure for preventing GVHD is the use of irradiated blood products. Furthermore unnecessary blood transfusion should be avoided.
我们报告一例喉癌患者发生的致命性输血相关移植物抗宿主病（GVHD）。给予39.6Gy照射剂量后，行全喉切除术并右颈根治性清扫术。术后过程顺利。然而，输血7天后，突然出现高热（38.5℃）。第9天，观察到水样腹泻和面部红斑。第12天，出现肝功能障碍和全血细胞减少。患者于第16天因严重脓毒症死亡。输血相关GVHD的死亡率超过90%。因此，预防GVHD最重要的措施是使用辐照血液制品。此外，应避免不必要的输血。
