[A case of bronchiolitis obliterans caused by allogeneic hematopoietic stem cell transplantation diagnosed with a body plethysmograph].
A 19-year-old woman with acute myeloid leukemia (M1) was treated with allogeneic hematopoietic stem cell transplantation. She was diagnosed with skin graft-versus-host disease 27 days after the transplantation. She was admitted to the Dept. of Respiratory Medicine at Kanazawa University Hospital, because she complained of progressive obstructive ventilatory impairment. A high-resolution computed tomography (CT) scan showed centrilobular small nodules. A chest CT scan (inspiratory phase and expiratory phase) revealed hyperlucent areas forming a mosaic pattern. A ventilation-perfusion scan showed matched unequal distribution. The pathological diagnosis made using biopsied lung, obtained by a right lower partial lobectomy, was constrictive bronchiolitis. Pulmonary function tests on admission showed mixed ventilatory impairment. %Residual volume(RV)/total lung capacity(TLC) was measured by the closed-circuit helium dilution method and was within the upper limit of the normal range. However, %RV/TLC measured by a body plethysmograph indicated a value of 258.1%. We believe that the difference in the %RV/TLC values reflected air trapping caused by bronchiolitis obliterans. Thus, the lung volume fraction measured by body plethysmograph was useful for diagnosing bronchiolitis obliterans in this case. [Rinsho Byori 58 : 906'-911, 2010].
Nakade
Yusuke
Y
Department of Clinical Laboratory, Kanazawa University Hospital, Kanazawa 920-8641, Japan. nakade-yusuke@umin.ac.jp
Fujimura
Masaki
M
Ohkura
Noriyuki
N
Waseda
Yuko
Y
Yamazakis
Hirohito
H
Inuzuka
Kanako
K
Ikeda
Hiroko
H
Oe
Hiroyasu
H
Nanbu
Yuko
Y
Takamuralo
Toshiji
T
Sakai
Yoshio
Y
Wada
Takashi
T
D000328:Adult; D001989:Bronchiolitis Obliterans / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D010993:Plethysmography, Whole Body