Graft-vs-host disease as a complication of lung transplantation

We report a rare case of acute graft-vs-host disease (aGVHD) after a lung transplant. The patient presented with advanced disease manifested by skin rash, fever, diarrhea, liver dysfunction and severe pancytopenia. He went on to die of sepsis and multi-organ failure. aGVHD is a disease often confused with drug reactions or viral infection; therefore, it is important to have a high index of suspicion and to confirm the diagnosis early with tests for donor cell chimerism. Effective treatment is elusive but we are learning a great deal about the underlying mechanisms of this disease and hope to develop better treatment.