トキタ　ダイスケ   TOKITA Daisuke   時田　大輔    所属   医学部 医学科（東京女子医科大学病院）    職種   非常勤講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Differential diagnosis between graft-versus-host disease and hemophagocytic syndrome after living-related liver transplantation by mixed lymphocyte reaction assay.
掲載誌名	正式名：Journal of investigative surgery : the official journal of the Academy of Surgical Research 略　 称：J Invest Surg ISSNコード：08941939/08941939
掲載区分	国外
巻・号・頁	17(4),pp.197-202
著者・共著者	Hara Hidetaka, Ohdan Hideki, Tashiro Hirotaka, Itamoto Toshiyuki, Tanaka Yuka, Mizunuma Kazuyuki, Tokita Daisuke, Onoe Takashi, Ito Reiko, Asahara Toshimasa
発行年月	2004/07
概要	Graft-versus-host disease (GVHD) after liver transplantation is uncommon but is a serious complication that can be fatal. Hemophagocytic syndrome (HPS), which is caused by activation of autologous T lymphocytes, is also a serious complication that can occur after liver transplantation. Because these complications share the clinical triad of skin rash, marrow failure, and diarrhea, differential diagnosis is difficult. We describe a case of severe GVHD resembling HPS in clinical features that occurred after living-related liver transplantation. The patient who had undergone the transplantation had high fever, pancytopenia, and skin rash 3 wk after the operation. Examination of a bone-marrow biopsy sample revealed the presence of abundant monocytes with phagocytosis, suggesting either GVHD or HPS. Donor human leukocyte antigens were detected in the peripheral blood of the patient by polymerase chain reaction, but this finding is not specific for GVHD. A definitive diagnosis was made by demonstration of remarkable anti-self response and undetectable anti-donor response in a mixed lymphocyte reaction assay using carboxyfluorescein diacetate succinimidyl ester.
DOI	10.1080/08941930490471966
PMID	15371161