Lopez James, Devarkonda Vishal, Thuzar Moe, Silva Roberto, Akabane Hugo
Hematology and Medical Oncology, Louisiana State University Health Sciences Center, Shreveport, USA.
Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, USA.
Cureus. 2023 Jun 14;15(6):e40415. doi: 10.7759/cureus.40415. eCollection 2023 Jun.
Acute graft vs. host disease (aGVHD) results from newly transplanted donor immune cells recognizing recipient tissues as foreign, leading to end-organ damage. Diagnosing aGVHD typically involves a combination of clinical evaluation, histological examination, laboratory tests, and imaging studies. Although typically associated with allogeneic stem cells transplant and less frequently with liver or small bowel transplants, solid organ transplant GVHD (SOT-GVHD) associated with kidney-pancreas transplants is exceedingly rare. Our patient presented with pancytopenia unexplained by typical causes. He developed classical aGVHD findings of fever, diarrhea, rash, and abnormal liver tests. Our case underscores the importance of keeping a broad differential when evaluating solid organ transplant patients.
急性移植物抗宿主病（aGVHD）是由新移植的供体免疫细胞将受体组织识别为外来组织所致，从而导致终末器官损伤。诊断aGVHD通常需要综合临床评估、组织学检查、实验室检查和影像学研究。虽然aGVHD通常与异基因干细胞移植相关，较少与肝脏或小肠移植相关，但与肾胰腺移植相关的实体器官移植GVHD（SOT-GVHD）极为罕见。我们的患者出现了典型病因无法解释的全血细胞减少。他出现了发热、腹泻、皮疹和肝功能异常等典型的aGVHD表现。我们的病例强调了在评估实体器官移植患者时保持广泛鉴别诊断的重要性。
