A Case of Fetal-Induced Graft-versus-Host Disease

This correspondence reports a rare case of graft-versus-host disease (GVHD) in a 32-year-old woman triggered by fetal T cells from her newborn twins. Symptoms (fever, pancytopenia, desquamating rash) developed three weeks postpartum. Biopsies confirmed CD8+ T-cell infiltration with 20–30% fetal DNA in affected tissues. The patient recovered rapidly with glucocorticoids, suggesting fetal T cells may be more glucocorticoid-sensitive than typical transfusion associated GVHD (TA-GVHD) cells. This case highlights potential underrecognized fetal maternal immune interactions

This correspondence reports a rare case of graft-versus-host disease (GVHD) in a 32-year-old woman triggered by fetal T cells from her newborn twins. Symptoms (fever, pancytopenia, desquamating rash) developed three weeks postpartum. Biopsies confirmed CD8+ T-cell infiltration with 20–30% fetal DNA in affected tissues. The patient recovered rapidly with glucocorticoids, suggesting fetal T cells may be more glucocorticoid-sensitive than typical transfusion associated GVHD (TA-GVHD) cells. This case highlights potential underrecognized fetal maternal immune interactions