A 55-year-old man who underwent allogeneic bone marrow transplantation for acute myeloid leukemia 6 weeks ago develops generalized erythematomatous skin rash, diarrhea, and elevated liver enzymes. Skin biopsy shows apoptotic keratinocytes and lymphocytic infiltration at the dermo-epidermal junction. Which cell type is primarily responsible for this condition?
- A Recipient B lymphocytes
- B Donor T lymphocytes ✓
- C Recipient NK cells
- D Donor plasma cells
Correct answer: B. Donor T lymphocytes
Explanation
Graft-versus-host disease (GVHD) occurs when immunocompetent donor T cells recognize recipient tissues as foreign and attack host cells, particularly skin, liver, and gastrointestinal tract. It requires the graft to contain immunocompetent cells, the recipient to express antigens not present in the donor, and the recipient to be incapable of mounting an immune response against the graft.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.