Abstract
The graft-vs-host (GVH) reaction occurred in an 11-month-old boy with thymic alymphoplasia and progressive vaccinia who had received a single whole blood transfusion. The principal manifestations of the GVH reaction were hepatosplenomegaly, dermatitis, diarrhea, aplastic anemia, and histiocytosis of the spleen and lymph nodes. The findings in this patient are similar to those of other previously reported cases of possible human runt disease. This case study emphasizes the dangers of smallpox vaccination or blood transfusion in infants with thymic alymphoplasia or one of the variants of this syndrome.