Six weeks after an allogeneic bone marrow transplant for aplastic anemia, a patient develops a maculopapular rash on palms and soles, watery diarrhea, and cholestatic jaundice. The effector cells mediating this complication are:

• A Recipient cytotoxic T cells attacking donor hematopoietic cells
• B Donor plasma cells producing antibodies against recipient platelets
• C Recipient natural killer cells activated by missing-self recognition
• D Donor mature T cells recognizing recipient tissues as foreign ✓

Explanation

Acute graft-versus-host disease results when immunocompetent donor T cells in the graft recognize recipient HLA antigens as foreign and attack host tissues. The classic triad targets skin, gastrointestinal tract, and liver (cholestatic jaundice). It occurs mainly after allogeneic hematopoietic transplantation because the graft itself contains viable donor lymphocytes. Recipient T cells would cause graft rejection, the opposite phenomenon.

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.