Pleuropericarditis, obliterative bronchiolitis and lymphocytic interstitial pneumonitis after allogeneic haematopoietic stem cell transplantation.
Chronic graft-versus-host disease (GVHD) is a common complication of allogeneic haematopoietic cell transplantation, with pulmonary involvement occurring in 5-10% of cases. Obliterative bronchiolitis (OB) is recognised as a diagnostic manifestation of chronic GVHD, whereas lymphocytic interstitial pneumonitis (LIP) has been reported but is not considered diagnostic, and pleuritis is not clearly associated. The authors describe a transplant patient who simultaneously manifested three distinct pulmonary processes: OB, patchy LIP and pleuropericarditis. The onset of these entities along with other manifestations of chronic GVHD, their resolution with increased immunosuppression and their recurrence upon tapering support all three entities as manifestations of GVHD in the lungs.
Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M D Anderson Cancer Center, Houston, Texas, USA. aalousi@mdanderson.org
Amin
A
Alousi
Somnath
S
Ghosh
David
D
Rice
Cesar
C
Moran
John T
JT
Manning
Cesar
C
Iliescu
Sharon
S
Hymes
Stella
S
Kim
Lara
L
Bashoura
Steven
S
Kornblau
Burton F
BF
Dickey
D000369:Aged, 80 and over; D001989:Bronchiolitis Obliterans / Q000209:etiology*; D006086:Graft vs Host Disease / Q000150:complications* / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000209:etiology*; D008214:Lymphocytes; D008297:Male; D010493:Pericarditis / Q000209:etiology*