RESUMO
A female with Hodgkin's disease developed graft versus host disease (GVHD) after the administration of two units of packed red cells. Ten days after the transfusion she developed fever and rash, with subsequent hepatic and intestinal disease and a profound bone marrow aplasia. She died from a Candida tropicalis sepsis. The diagnosis of GVHD was made on the basis of clinical and histological criteria. We review this uncommon complication of hemotherapy, with special emphasis on its differential clinical features and its prevention.
Assuntos
Candidíase/complicações , Transfusão de Eritrócitos , Doença Enxerto-Hospedeiro/etiologia , Doença de Hodgkin/terapia , Reação Transfusional , Adulto , Feminino , Doença Enxerto-Hospedeiro/patologia , Doença de Hodgkin/complicações , HumanosRESUMO
Total hemolytic complement (CH50) and eight antigenic fractions of the complement system were determined in 30 patients with hematological neoplasias, distributed into the following groups: six cases of non-Hodgkin's lymphomas (NHL), seven cases of chronic lymphocytic leukemia (CLL), five cases of Hodgkin's disease (HD), seven cases of acute leukemia (AL), three cases of chronic myeloid leukemia (CML) and two cases of multiple myeloma (MM). CH50 was titred accordingly to a modification of the Kabat and Mayer method, C1q, C1s, C3, C4, C5, INHC1, C3A and properdin were determined with specific antisera by Manani and Laurell's techniques. The results obtained showed significant increase in CH50 above normal values in patients with HD, AL, and CML, especially the former, even in early stages. C1s was found to be increased in CML and AL, as well as C3 in CML. C4 is increased in CML and HD. C5 follows a course similar to C4, being also increased CLL and MM. C9 is increased in all groups, except NHL. A significant increase in C3A was found in NHL, HD and AL. There were no significant variations in C1s, INHC1 and properdin in any of the former groups. No correlation was found between clinical course and complement increase. The role of complement in neoplastic disease is discussed.
