Transfusion-associated graft-versus-host disease in an immunocompetent individual

BMJ Case Rep. 2024 Oct 30;17(10):e261429. doi: 10.1136/bcr-2024-261429.

Abstract

Transfusion-associated graft-versus-host disease (TA-GVHD) is a fatal complication that occurs in both immunocompromised and immunocompetent individuals following blood transfusion. It is characterised by donor lymphocyte attacks on recipient tissues. We present a case of TA-GVHD in an immunocompetent man in his 70s who developed fever, diarrhoea, rash and pancytopenia after non-irradiated blood transfusion from an unrelated donor. Despite aggressive treatment, the patient's condition deteriorated leading to his death, highlighting the challenges in recognising and managing TA-GVHD. This case emphasises considering TA-GVHD as a differential diagnosis in patients exhibiting symptoms post-transfusion, particularly in populations with high rates of consanguinity. This raises the likelihood that a population will have a high prevalence of a certain human leucocyte antigen. Prevention strategies, such as irradiation of blood products, are essential in reducing the risk of TA-GVHD. In this case, TA-GVHD affected an immunocompetent individual after receiving blood from unrelated donors, highlighting the importance of vigilance.

Keywords: Haematology (drugs and medicines); Haematology (incl blood transfusion); Pathology; Prevention; Skin.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Diagnosis, Differential
  • Fatal Outcome
  • Graft vs Host Disease* / diagnosis
  • Graft vs Host Disease* / etiology
  • Humans
  • Immunocompetence
  • Male
  • Pancytopenia / etiology
  • Transfusion Reaction* / diagnosis