[Bronchiolitis obliterans in a patient with chronic graft-versus-host disease after bone marrow transplantation].
A 25-year-old with acute lymphoblastic leukemia (FAB:L2) received an allogeneic bone marrow transplant from an HLA-identical sibling during the first remission. Despite administration of adequate immunosuppressant drugs, active chronic graft-versus-host disease developed and continued. The patient complained of progressive dry coughing and breathlessness on exertion 18 months after the transplant and severe hyperlucency and multiple bullae were observed on a chest X-ray film. Three years after the transplant, recurrent bilateral pneumothorax developed and lung cysts were resected twice. Histological examination revealed bronchiolitis obliterans. We speculate that post-transplant bronchiolitis obliterans caused multiple bullae to form by a check-valve mechanism, which then led to recurrent bilateral pneumothorax.
Matsumoto
K
K
Department of Internal Medicine, Toki General Hospital, Gifu, Japan.
Yamauchi
T
T
Ichikawa
M
M
Masuda
Y
Y
Ogawa
K
K
Arai
T
T
Ito
M
M
Yamashita
Y
Y
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D001989:Bronchiolitis Obliterans / Q000209:etiology* / Q000473:pathology; D002908:Chronic Disease; D006086:Graft vs Host Disease / Q000209:etiology*; D006801:Humans; D008297:Male; D011030:Pneumothorax / Q000209:etiology* / Q000473:pathology; D012008:Recurrence; D014184:Transplantation, Homologous