Etiology of erythrodermia after open heart surgery: Y chromatin analysis of lymphocytes
Fuse, K.; Konishi, T.; Makuuchi, H.; Kukita, M.; Matsushita, H.; Shibata, Y.
Nihon Kyobu Geka Gakkai 36(12): 2646-2650
1988
ISSN/ISBN: 0369-4739 PMID: 2466921 Document Number: 309613
Postoperative erythrodermia is a fatal complication after open heart surgery, and it had been suspected to be due to drug allergy. In recent years, posttransfusion graft-versus-host reaction (GVHR) has been considered to be the etiology of this syndrome, but the evidence of this hypothesis has not been demonstrated. We experienced 2 fatal postoperative erythrodermia following fresh blood transfusion given to patients receiving coronary bypass grafting. Posttransfusion GVHR was suspected by clinical course and pathological findings of the skin in these cases. To clarify the pathogenesis, Y chromatin analysis of the female case was performed on separated cells from the skin, spleen and bone marrow which had been fixed in 10% formalin and then embedded in paraffin. Y chromatin could be identified in lymphocytes in every tissue of the case examined. These findings show that the lymphocytes originating from the male donor invade female organs, i.e. the pathogenesis of this syndrome is GVHR. This is the first case demonstrating that the etiology of erythrodermia following open heart surgery is posttransfusion GVHR.