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Article: Evans' syndrome complicating chronic graft versus host disease after cadaveric liver transplantation

TitleEvans' syndrome complicating chronic graft versus host disease after cadaveric liver transplantation
Authors
Issue Date2001
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.transplantjournal.com
Citation
Transplantation, 2001, v. 72 n. 3, p. 527-528 How to Cite?
AbstractAcute graft versus host disease (GVHD) occurred in a patient after cadaveric liver transplantation from an HLA disparate donor. Immunosuppression resulted in a remission, but chronic GVHD with a sclerodermalike syndrome ensued. This was further complicated by immune hemolytic anemia and thrombocytopenia (Evan's syndrome). Semi-quantitative microsatellite analysis of circulating lymphoid cells showed that T cells were predominantly of donor origin, thereby explaining the chronic GVHD. The marrow hematopoietic cells remained recipient, so that the immune cytopenias were expected to be alloimmune in nature. However, the red cell antibodies were shown to have anti-C and anti-e specificity, with both the donor (R 1R 1) and recipient (R 1r) possessing the C and e antigens. Therefore, the immune hemolysis might be considered both alloimmune and autoimmune. The patient finally died of sepsis. This case illustrates that chronic GVHD due to stable donor T cell engraftment may rarely occur in liver transplantation despite HLA disparity. Immunosuppression may result in dysregulation of T cell functions, leading to alloimmune and autoimmune problems.
Persistent Identifierhttp://hdl.handle.net/10722/76953
ISSN
2015 Impact Factor: 3.69
2015 SCImago Journal Rankings: 1.699
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorAu, WYen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorHawkins, BRen_HK
dc.contributor.authorMa, ESen_HK
dc.contributor.authorLie, AKen_HK
dc.contributor.authorKwong, YLen_HK
dc.date.accessioned2010-09-06T07:26:42Z-
dc.date.available2010-09-06T07:26:42Z-
dc.date.issued2001en_HK
dc.identifier.citationTransplantation, 2001, v. 72 n. 3, p. 527-528en_HK
dc.identifier.issn0041-1337en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76953-
dc.description.abstractAcute graft versus host disease (GVHD) occurred in a patient after cadaveric liver transplantation from an HLA disparate donor. Immunosuppression resulted in a remission, but chronic GVHD with a sclerodermalike syndrome ensued. This was further complicated by immune hemolytic anemia and thrombocytopenia (Evan's syndrome). Semi-quantitative microsatellite analysis of circulating lymphoid cells showed that T cells were predominantly of donor origin, thereby explaining the chronic GVHD. The marrow hematopoietic cells remained recipient, so that the immune cytopenias were expected to be alloimmune in nature. However, the red cell antibodies were shown to have anti-C and anti-e specificity, with both the donor (R 1R 1) and recipient (R 1r) possessing the C and e antigens. Therefore, the immune hemolysis might be considered both alloimmune and autoimmune. The patient finally died of sepsis. This case illustrates that chronic GVHD due to stable donor T cell engraftment may rarely occur in liver transplantation despite HLA disparity. Immunosuppression may result in dysregulation of T cell functions, leading to alloimmune and autoimmune problems.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.transplantjournal.comen_HK
dc.relation.ispartofTransplantationen_HK
dc.rightsTransplantation. Copyright © Lippincott Williams & Wilkins.en_HK
dc.subject.meshAdulten_HK
dc.subject.meshAnemia, Hemolytic - etiologyen_HK
dc.subject.meshCadaveren_HK
dc.subject.meshChronic Diseaseen_HK
dc.subject.meshFatal Outcomeen_HK
dc.subject.meshGraft vs Host Disease - etiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLiver Transplantation - adverse effectsen_HK
dc.subject.meshMaleen_HK
dc.subject.meshSyndromeen_HK
dc.subject.meshThrombocytopenia - etiologyen_HK
dc.titleEvans' syndrome complicating chronic graft versus host disease after cadaveric liver transplantationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0041-1337&volume=72&issue=3&spage=527&epage=528&date=2001&atitle=Evans%27+syndrome+complicating+chronic+graft+versus+host+disease+after+cadaveric+liver+transplantationen_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailKwong, YL: ylkwong@hku.hken_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityKwong, YL=rp00358en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid11502987-
dc.identifier.scopuseid_2-s2.0-0035881765en_HK
dc.identifier.hkuros67885en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035881765&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume72en_HK
dc.identifier.issue3en_HK
dc.identifier.spage527en_HK
dc.identifier.epage528en_HK
dc.identifier.isiWOS:000170587000028-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridAu, WY=7202383089en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridHawkins, BR=35944486200en_HK
dc.identifier.scopusauthoridMa, ES=7202039934en_HK
dc.identifier.scopusauthoridLie, AK=24284842400en_HK
dc.identifier.scopusauthoridKwong, YL=7102818954en_HK

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