Possible graft-versus-host reaction after intrauterine transfusion for Rh erythroblastosis fetalis.
Possible graft-versus-host reaction after intrauterine transfusion for Rh erythroblastosis fetalis.
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胎儿成红细胞增多症宫内输血后可能出现移植物抗宿主反应。
DOI：
10.1056/nejm196909252811303
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发表时间：
1969
期刊：
影响因子：
--
通讯作者：
J. Arey
中科院分区：
文献类型：
--
作者：
J. Naiman;H. Punnett;H. Lischner;M. L. Destine;J. Arey
一名八周大的婴儿因Rh成红细胞增多症胎儿而接受三次宫内输血后存活下来，并发生以黄疸、再生障碍性贫血和骨髓中显著的组织细胞反应为特征的疾病。外周血淋巴细胞培养表明，两个群体的淋巴细胞的基础上的差异，Y染色体长度。其中一个类似于子宫内输血的供体之一。尽管最初的血液学改善，婴儿的病情恶化，多重感染和进行性体重下降，直到13周龄死亡。尽管尸检时淋巴和胸腺萎缩明显，但认为这些变化反映了萎缩（继发于移植物抗宿主反应），而不是原发性免疫缺陷病。这一观察结果支持了其他人的建议，即用于输注胎儿的血液应首先去除活淋巴细胞。
Abstract An illness characterized by jaundice, aplastic anemia and striking histiocytic reaction in the bone marrow developed in an eight-week-old infant who survived three intrauterine transfusions for Rh erythroblastosis fetalis. Culture of peripheral blood lymphocytes suggested two populations of lymphocytes based on differences in Y-chromosome length. One of these resembled that of one of the donors of the intrauterine blood transfusions. In spite of initial hematologic improvement the infant's condition deteriorated, with multiple infections and progressive weight loss until death at 13 weeks of age. Although lymphoid and thymic atrophy were evident at autopsy these changes were considered to reflect atrophy (secondary to a graft-versus-host reaction) rather than primary immunologic deficiency disease. This observation supports recommendations of others that blood intended for transfusion to the fetus be first rendered free of viable lymphocytes.