Brown Timothy J, Gentry Cathy, Hammer Suntrea T G, Hwang Christine S, Vusirikala Madhuri, Patel Prapti A, Matevosyan Karén, Tujios Shannan R, Mufti Arjmand R, Collins Robert H
Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX.
University of Texas Southwestern Medical School, Dallas, TX.
ACG Case Rep J. 2017 Mar 29;4:e48. doi: 10.14309/crj.2017.48. eCollection 2017.
A 48-year-old man with hepatitis C virus (HCV) cirrhosis complicated by hepatocellular carcinoma underwent liver transplantation. His course was complicated by fever, diarrhea, abdominal pain, and pancytopenia. He developed a diffuse erythematous rash, which progressed to erythroderma. Biopsies of the colon and skin were consistent with acute graft-versus-host disease. Donor-derived lymphocytes were present in the peripheral blood. The patient was treated with corticosteroids and cyclosporine; however, he had minimal response to intensive immunosuppressive therapy. Extracorporeal photopheresis was initiated as a salvage therapy. He had a dramatic response, and his rash, diarrhea, and pancytopenia resolved. He is maintained on minimal immunosuppression 24 months later.
一名48岁的丙型肝炎病毒（HCV）肝硬化合并肝细胞癌患者接受了肝移植。他的病程中出现了发热、腹泻、腹痛和全血细胞减少等并发症。他出现了弥漫性红斑皮疹，进展为红皮病。结肠和皮肤活检结果与急性移植物抗宿主病相符。外周血中存在供体来源的淋巴细胞。患者接受了皮质类固醇和环孢素治疗；然而，他对强化免疫抑制治疗反应甚微。开始采用体外光化学疗法作为挽救治疗。他有显著反应，皮疹、腹泻和全血细胞减少均得到缓解。24个月后，他维持最低限度的免疫抑制治疗。
