Akhtari M, Langston A A, Waller E K, Gal A A
Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USA.
Bone Marrow Transplant. 2009 Jan;43(2):155-8. doi: 10.1038/bmt.2008.302. Epub 2008 Sep 15.
Eosinophilic pulmonary syndrome is an uncommon problem in SCT recipients that can mimic an infectious process. We report the occurrence of eosinophilic pulmonary syndrome in three patients following allogeneic hematopoietic stem cell transplantation (HSCT), and postulate that this entity is part of the clinicopathologic spectrum of pulmonary GVHD. In all three cases, active chronic GVHD of the skin preceded or coincided with the development of pulmonary involvement. Other common features included peripheral blood eosinophilia, diffuse bilateral pulmonary infiltrates and lung biopsies showing pronounced infiltrates of eosinophils involving the small bronchioles. All patients responded promptly to systemic steroid therapy, with improvement of their pulmonary symptoms and the resolution of peripheral blood eosinophilia. Clinicians should be aware that eosinophilic pulmonary syndrome can occur following HSCT, may be associated with other manifestations of chronic GVHD, and generally responds well to corticosteroid therapy.
嗜酸性粒细胞性肺综合征在造血干细胞移植（SCT）受者中是一个不常见的问题，可类似感染性过程。我们报告了3例异基因造血干细胞移植（HSCT）后发生嗜酸性粒细胞性肺综合征的病例，并推测该实体是肺部移植物抗宿主病（GVHD）临床病理谱的一部分。在所有3例病例中，皮肤的活动性慢性GVHD在肺部受累之前出现或与之同时发生。其他常见特征包括外周血嗜酸性粒细胞增多、双侧弥漫性肺部浸润以及肺活检显示嗜酸性粒细胞显著浸润累及小支气管。所有患者对全身类固醇治疗反应迅速，肺部症状改善，外周血嗜酸性粒细胞增多消退。临床医生应意识到HSCT后可发生嗜酸性粒细胞性肺综合征，可能与慢性GVHD的其他表现相关，且通常对皮质类固醇治疗反应良好。
