Noji S, Kitamura N, Yamaguchi A, Miki T, Otaki M, Tamura H
Department of Cardiovascular Surgery, Osaka National Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Oct;39(10):1909-13.
So-called "Postoperative Erythroderma" was experienced in a 68 year-old man who received CABG for unstable angina. After a seemingly uneventful recovery, he revealed high grade fever on 13th post operative day (POD), rashes over the whole body on 15th POD and pancytopenia on 20th POD. He died of sepsis, multiple organ failure and DIC on 21st POD. Blood transfusion (concentrated red cell: 3 units) was done on operation. In this case, the rate of premature and atypical lymphocytes increased, and the ratio of OKT4 (helper)/OKT8 (suppressor) decreased. These findings of the examination suggested that there was a possibility of cell-mediated immunological depression. We considered this to be acute GVHD after blood transfusion.
一名68岁男性因不稳定型心绞痛接受冠状动脉旁路移植术（CABG）后出现了所谓的“术后红皮病”。在看似平稳的恢复过程后，他在术后第13天出现高热，术后第15天全身出现皮疹，术后第20天出现全血细胞减少。他于术后第21天死于败血症、多器官功能衰竭和弥散性血管内凝血（DIC）。手术中进行了输血（浓缩红细胞：3单位）。在该病例中，早幼和非典型淋巴细胞比例增加，OKT4（辅助性）/OKT8（抑制性）比值降低。这些检查结果提示存在细胞介导的免疫抑制可能性。我们认为这是输血后急性移植物抗宿主病（GVHD）。
