Kumamoto H, Abe K, Sawai T, Hu S X, Akaishi T, Ooya K
Department of Oral Pathology, Tohoku University School of Dentistry, Sendai.
Tohoku J Exp Med. 1996 Aug;179(4):281-9. doi: 10.1620/tjem.179.281.
An autopsy case of transfusion-associated graft-versus-host disease (TA-GVHD) is reported with immunohistochemical investigation and polymerase chain reaction (PCR) analysis. In a 58-year-old male, esophagectomy for carcinoma was performed with a transfusion of 4 units of fresh whole blood. Diarrhea, fever, erythematous rash, pain and leukopenia occurred with an onset 11 days after the operation. He died of sudden dyspnea 29 days after the operation. At autopsy, histological examinations revealed lichenoid lesion in the skin, injury of mucosal epithelia in the digestive tract and damage of interlobular bile ducts in the liver. Immunohistochemical investigation suggested the association between these lesions and CD8-positive T lymphocytes. Severe disturbances of bone marrow and lymphoid organs were accompanied with gram-positive cocci infection in the lungs, esophagus and small intestine. PCR analysis of DNA at microsatellite loci, human growth hormone (HGH) and apolipoprotein B (Apo B), showed DNA chimerism and established the definitive diagnosis of TA-GVHD.
报告了1例经免疫组织化学研究和聚合酶链反应（PCR）分析的输血相关移植物抗宿主病（TA-GVHD）尸检病例。一名58岁男性因食管癌接受了食管切除术，并输注了4单位新鲜全血。术后11天出现腹泻、发热、红斑皮疹、疼痛和白细胞减少。术后29天，他因突发呼吸困难死亡。尸检时，组织学检查显示皮肤有苔藓样病变、消化道黏膜上皮损伤和肝小叶间胆管损伤。免疫组织化学研究提示这些病变与CD8阳性T淋巴细胞有关。骨髓和淋巴器官严重受累，同时肺部、食管和小肠存在革兰氏阳性球菌感染。对微卫星位点、人生长激素（HGH）和载脂蛋白B（Apo B）的DNA进行PCR分析，显示出DNA嵌合现象，从而确诊为TA-GVHD。
