Panpruang Pitirat, Eksombatchai Dararat, Boonsarngsuk Viboon
Division of Pulmonary and Pulmonary Critical Care Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital Mahidol University Bangkok Thailand.
Division of Pulmonary and Pulmonary Critical Care Medicine, Department of Medicine, Faculty of Medicine Srinakharinwirot University Ongkharak Thailand.
Respirol Case Rep. 2024 Apr 30;12(5):e01348. doi: 10.1002/rcr2.1348. eCollection 2024 May.
Tracheobronchomalacia (TBM) occurs due to the weakening of cartilaginous part of the trachea, resulting in compromised airway function and leading to symptoms such as dyspnea, cough, and inability to clear secretions. Bronchiolitis obliterans syndrome (BOS) is the most prevalent late noninfectious pulmonary complication in patients who underwent allogeneic haematopoietic stem cell transplantation (HSCT). Therefore, patients experiencing progressive dyspnea and chronic cough after allogenic HSCT, with new obstructive pattern on pulmonary function test, are typically diagnosed with post-transplant BOS. However, it is important to note that TBM can also manifest as an obstructive defect pattern on pulmonary function test. Tracheomalacia has been reported as a rare complication of allogenic stem cell transplantation. We present two patients who developed TBM following allogeneic HSCT and were initially treated for post-transplant BOS but did not experience symptom improvement. However, after treatment with continuous positive airway pressure, their symptom subsided.
气管支气管软化症（TBM）是由于气管软骨部分减弱而发生的，导致气道功能受损，并引发诸如呼吸困难、咳嗽和无法清除分泌物等症状。闭塞性细支气管炎综合征（BOS）是接受异基因造血干细胞移植（HSCT）患者中最常见的晚期非感染性肺部并发症。因此，在异基因HSCT后出现进行性呼吸困难和慢性咳嗽，且肺功能测试出现新的阻塞模式的患者，通常被诊断为移植后BOS。然而，需要注意的是，TBM在肺功能测试中也可表现为阻塞性缺陷模式。气管软化症已被报道为异基因干细胞移植的一种罕见并发症。我们报告了两名在异基因HSCT后发生TBM的患者，他们最初接受了移植后BOS的治疗，但症状并未改善。然而，在接受持续气道正压通气治疗后，他们的症状得到了缓解。
