Solitary pulmonary cholesteroloma, multiple xanthelasmas and lipemia retinalis complicating hypercholesterolemia after bone marrow transplantation.
A 22-year-old female with diffuse mixed T cell lymphoma in second complete remission underwent allogeneic BMT from her HLA-compatible brother. Transplantation was complicated by acute graft-versus-host disease (GVHD), cytomegalovirus (CMV) infection, and combined hepatotoxic/cholestatic liver disease 45 days post-BMT. Cholesterol levels reached 65 mmol/l, and high density lipoprotein (HDL) cholesterol decreased to 0.23 mmol/l. She developed skin xanthelasmas, lipemia retinalis, and a solitary lung lesion, which was clinically diagnosed as pulmonary cholesteroloma. All these complications resolved following plasmapheresis and hypolipidemic treatment with lovastatin and cholesterol levels normalized.
Toren
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Department of Bone Marrow Transplantation, Hadassah University Hospital, Jerusalem, Israel.
Nagler
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D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003586:Cytomegalovirus Infections / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications*; D008171:Lung Diseases / Q000209:etiology*; D012164:Retinal Diseases / Q000209:etiology*; D014973:Xanthomatosis / Q000209:etiology*