title: A new pattern of pulmonary graft vs host disease in a hematopoietic stem cell transplant patient.
abstract: BACKGROUND
  The primary pulmonary manifestation of chronic graft vs host disease (GvHD) is the development of bronchiolitis obliterans. Other pulmonary manifestations of chronic GvHD that have been reported include diffuse alveolar damage, lymphocytic interstitial pneumonia, bronchiolitis organising pneumonia and lymphocytic bronchiolitis/bronchitis.
  
  
  METHODS
  We report an unusual case of a 34-year-old patient with acute myeloid leukaemia, status post-allogenic hematopoietic stem cell transplantation who subsequently developed GvHD with skin involvement. He presented to our hospital with new onset respiratory failure and on subsequent surgical lung biopsy was found to have non-specific interstitial pneumonia (NSIP).
  
  
  CONCLUSIONS
  This is the third case of a patient with biopsy-proven GvHD who had NSIP pattern on surgical lung biopsy. We believe this may represent a rare manifestation of pulmonary GvHD.
authors.affiliation: Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan.
authors.forename: Ali S
authors.initials: AS
authors.lastname: Wahla
authors.affiliation: Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan.
authors.forename: Irtaza I
authors.initials: II
authors.lastname: Khan
authors.affiliation: Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan.
authors.forename: Asif
authors.initials: A
authors.lastname: Loya
authors.affiliation: Pulmonary and Critical Care Division, Wake Forest University Baptist Medical Center, Winston Salem, NC, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Chin
mesh_terms: D000328:Adult; D001706:Biopsy; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008168:Lung / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000209:etiology* / Q000473:pathology; D008297:Male
keywords: graft vs host disease; hematopoietic stem cell transplant; non-specific interstitial pneumonia; respiratory failure