Immunocompetent patient with transfusion-associated graft-versus-host disease (TA-GVHD): a case report and literature review

Transfusion-associated graft-versus-host disease (TA-GVHD) is a rare and potentially lethal complication of blood transfusion. It occurs when transfused immune cells, such as lymphocytes, elicit an immune response against the recipient’s tissues, including the skin, bone marrow, and gastrointestinal tract. TA-GVHD leads to severe pancytopenia, resulting in increased vulnerability to severe, often untreatable infections. Although the pathogenesis of TA-GVHD is fairly well understood, management remains challenging given the paucity of successful outcomes. We present a case of an immunocompetent 40-year-old Yemeni male who developed TA-GVHD after receiving a single unit of irradiated blood from his brother. The transfusion was done prior to an upper endoscopy procedure that confirmed the diagnosis of a peptic ulcer disease after which the patient was treated appropriately. He presented later with severe dyspnea and productive cough, necessitating oxygen support via face mask. The patient rapidly deteriorated with unstable vitals and was subsequently intubated and mechanically ventilated. Unfortunately, the patient died later due to cardiopulmonary compromise despite appropriate resuscitative measures. In summary, TA-GVHD is a serious condition that attacks the recipient’s tissues and results in severe pancytopenia.