{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:40:22Z","timestamp":1756280422305,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,9,18]]},"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p>Transfusion-associated graft-versus-host disease (TA-GVHD) is a fatal complication that occurs in both immunocompromised and immunocompetent individuals following blood transfusion. It is characterised by donor lymphocyte attacks on recipient tissues. We present a case of TA-GVHD in an immunocompetent man in his 70s who developed fever, diarrhoea, rash and pancytopenia after non-irradiated blood transfusion from an unrelated donor. Despite aggressive treatment, the patient\u2019s condition deteriorated leading to his death, highlighting the challenges in recognising and managing TA-GVHD. This case emphasises considering TA-GVHD as a differential diagnosis in patients exhibiting symptoms post-transfusion, particularly in populations with high rates of consanguinity. This raises the likelihood that a population will have a high prevalence of a certain human leucocyte antigen. Prevention strategies, such as irradiation of blood products, are essential in reducing the risk of TA-GVHD. In this case, TA-GVHD affected an immunocompetent individual after receiving blood from unrelated donors, highlighting the importance of vigilance.<\/jats:p>","DOI":"10.1136\/bcr-2024-261429","type":"journal-article","created":{"date-parts":[[2024,10,30]],"date-time":"2024-10-30T11:24:13Z","timestamp":1730287453000},"page":"e261429","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Transfusion-associated graft-versus-host disease in an immunocompetent individual"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8479-3210","authenticated-orcid":false,"given":"Midrar","family":"Ullah","sequence":"first","affiliation":[{"name":"Internal Medicine, The Aga Khan University, Karachi, Sindh, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8686-3744","authenticated-orcid":false,"given":"Syed Muhammad Hassan","family":"hassan","sequence":"additional","affiliation":[{"name":"Internal Medicine, The Aga Khan University, Karachi, Sindh, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2512-6454","authenticated-orcid":false,"given":"Muhammad Mehmood","family":"riaz","sequence":"additional","affiliation":[{"name":"Internal Medicine, The Aga Khan University, Karachi, Sindh, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2274-2200","authenticated-orcid":false,"given":"Syed Ahsan","family":"Ali","sequence":"additional","affiliation":[{"name":"Internal Medicine, The Aga Khan University, Karachi, Sindh, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,10,30]]},"reference":[{"key":"2025082623582440000_17.10.e261429.1","article-title":"Transfusion-Associated Graft-Versus-Host Disease in Adults","volume":"15","author":"Elmakki","year":"2023","journal-title":"Cureus"},{"key":"2025082623582440000_17.10.e261429.2","doi-asserted-by":"crossref","first-page":"103406","DOI":"10.1016\/j.transci.2022.103406","article-title":"How is transfusion-associated graft-versus-host disease similar to, yet different from, organ transplantation-associated graft-versus-host disease?","volume":"61","author":"Sato","year":"2022","journal-title":"Transfus Apher Sci"},{"key":"2025082623582440000_17.10.e261429.3","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-01-620872"},{"key":"2025082623582440000_17.10.e261429.4","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2002.03450.x"},{"key":"2025082623582440000_17.10.e261429.5","first-page":"69","article-title":"Mechanism of transfusion-associated graft-versus-host disease","volume":"39","author":"Yasuda","year":"1993","journal-title":"Fukushima J Med Sci"},{"key":"2025082623582440000_17.10.e261429.6","doi-asserted-by":"crossref","first-page":"177","DOI":"10.2302\/kjm.38.177","article-title":"Two cases of postoperative erythroderma","volume":"38","author":"Haga","year":"1989","journal-title":"Keio J Med"},{"key":"2025082623582440000_17.10.e261429.7","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1016\/S0140-6736(86)90496-4","article-title":"Post-transfusion graft-versus-host disease after open heart surgery","volume":"2","author":"Sakakibara","year":"1986","journal-title":"Lancet"},{"key":"2025082623582440000_17.10.e261429.8","doi-asserted-by":"publisher","DOI":"10.3109\/10428199409049718"},{"key":"2025082623582440000_17.10.e261429.9","first-page":"285","article-title":"Prevention of transfusion-associated graft-vs-host disease","volume":"113","author":"Holland","year":"1989","journal-title":"Arch Pathol Lab Med"},{"key":"2025082623582440000_17.10.e261429.10","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.jaad.2011.11.960","article-title":"Graft-versus-host disease: part I. 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