مريض عمره ٤٠ سنة بعد زراعة نخاع من متبرع بشهر، عنده طفح أحمر على الكفين والقدمين ثم انتشر، وإسهال غزير، ويرقان. ما الأرجح؟

A 40-year-old a month after a donor stem cell transplant develops a red rash on the palms and soles that spreads, profuse diarrhoea and jaundice. What is most likely?

1. Sunburn
2. Simple viral gastroenteritis
3. A soap allergy only
4. Graft-versus-host disease

Answer: D) Graft-versus-host disease. Donor immune cells attack the recipient’s skin, gut and liver, causing rash, diarrhoea and jaundice, treated with more immunosuppression and steroids.