Ishida T, Arita M, Fujimori N
Department of Internal Medicine, Kurashiki Central Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Mar;34(3):369-73.
A 44-year-old woman with malignant T-cell lymphoma and secondary leukemia received an allogeneic bone marrow transplant (BMT). She had received BMT conditioning treatment with total body irradiation and chemotherapy. Hemoptysis and progressive dyspnea developed 11 days after the transplant. A chest roentgenogram showed bilateral diffuse infiltrates. Bronchoalveolar lavage fluid was bloody, and diffuse alveolar hemorrhage (DAH) was diagnosed. Respiratory failure progressed despite mechanical ventilation and administration of corticosteroids. The patient died 58 days after the transplant DAH after BMT has been recognized in western countries as a syndrome with high mortality. We draw attention to the fact that DAH is a serious early pulmonary complication of BMT also in Japan.
一名44岁患有恶性T细胞淋巴瘤和继发性白血病的女性接受了异基因骨髓移植(BMT)。她接受了全身照射和化疗的BMT预处理治疗。移植后11天出现咯血和进行性呼吸困难。胸部X线片显示双侧弥漫性浸润。支气管肺泡灌洗液呈血性,诊断为弥漫性肺泡出血(DAH)。尽管进行了机械通气和给予皮质类固醇,呼吸衰竭仍在进展。患者在移植后58天死亡。在西方国家,BMT后的DAH被认为是一种死亡率很高的综合征。我们提请注意,在日本,DAH也是BMT严重的早期肺部并发症。