Nakanishi Norihiko, Kojima Kensuke, Ueda Nobuo, Moritaka Tomonori
Department of Medicine, Ehime Prefecture Central Hosptial, Matsuyama, 790-0024, Japan.
Nihon Kokyuki Gakkai Zasshi. 2002 May;40(5):408-11.
A case of bronchiolitis obliterans after allogeneic bone marrow transplantation (BMT) for acute lymphocytic leukemia in an 18-year-old woman with both acute and chronic graft-versus-host disease is described. About 160 days after BMT she started complaining of a non-productive cough and exertional dyspnea. Pulmonary function testing revealed obstructive respiratory dysfunction. High-resolution CT (HRCT) scan of the lungs showed areas of parenchymal hypoattenuation with air-trapping, which was more emphasized with expiratory HRCT. She had many of the risk factors for bronchiolitis obliterans, such as total body irradiation, pretreatment with cyclophosphamide, chronic graft-versus-host disease and a low IgG level. Her symptoms were progressive and bronchiectasis developed. She died of respiratory failure 3.5 years after BMT. Bronchiolitis obliterans is an important complication of BMT which the clinician must take into account.
描述了一名18岁患有急性和慢性移植物抗宿主病的女性，在接受异基因骨髓移植（BMT）治疗急性淋巴细胞白血病后发生闭塞性细支气管炎的病例。BMT后约160天，她开始抱怨干咳和劳力性呼吸困难。肺功能测试显示阻塞性呼吸功能障碍。肺部高分辨率CT（HRCT）扫描显示实质密度减低区伴有空气潴留，呼气HRCT时更为明显。她有许多闭塞性细支气管炎的危险因素，如全身照射、环磷酰胺预处理、慢性移植物抗宿主病和低IgG水平。她的症状呈进行性发展，出现了支气管扩张。BMT 3.5年后，她死于呼吸衰竭。闭塞性细支气管炎是BMT的一种重要并发症，临床医生必须予以考虑。
