Lymphocytic bronchitis associated with graft-versus-host disease in recipients of bone-marrow transplants.
Graft-versus-host disease, a complication of allogeneic bone-marrow transplantation, involves primarily the skin, liver and intestines, but may also be associated with pneumonia. To determine the relation of graft-versus-host disease with pneumonia, we evaluated the autopsies of 59 allogeneic and two autologous recipients and 74 control patients with various pulmonary diseases, who had not received a bone-marrow transplant. Lymphocytic bronchitis, characterized by lymphocyte-associated necrosis of the bronchial mucosa and often the submucosal glands, was present in 12 of 20 patients with Grade 2 or greater graft-versus-host disease but in only three of 39 with Grade 0 to 1 disease (P less than 0.0005). Onset of respiratory disease correlated with the time of onset of graft-versus-host disease. Patients with lymphocytic bronchitis had a higher incidence of bronchopneumonia and acute bronchitis of the lower respiratory tract. Lymphocytic bronchitis did not occur in the controls and appears to be a component of graft-versus-host disease that leads to bronchopneumonia, probably through destruction of the mucociliary apparatus.
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D001980:Bronchi / Q000473:pathology; D001991:Bronchitis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006087:Graft vs Host Reaction; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D009336:Necrosis; D011014:Pneumonia / Q000209:etiology; D012136:Respiratory Syncytial Viruses; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014777:Virus Diseases / Q000175:diagnosis