Lymphocytic pneumonitis as the manifestation of acute graft‐versus‐host disease of the lung
Lymphocytic pneumonitis as the manifestation of acute graft‐versus‐host disease of the lung
复制标题
淋巴细胞性肺炎是肺部急性移植物抗宿主病的表现
DOI：
--
复制
发表时间：
2005
期刊：
影响因子：
--
通讯作者：
G. Akpek
中科院分区：
文献类型：
--
作者：
J. Bolaños;O. Ioffe;J. C. Hey;G. Vogelsang;G. Akpek
急性移植物抗宿主病是异基因干细胞移植后的常见并发症。它通常会影响皮肤，肝脏和肠道。我们报告了一名54岁男性患者，在HLA匹配的异基因外周血干细胞移植后165天出现呼吸急促、咳嗽和双侧肺浸润，检查未能证实感染病因。18天前，他的他克莫司剂量逐渐减少，入院时剂量低于治疗剂量。经支气管活检显示血管周围和间质淋巴细胞浸润，组织学或广泛检查无明显病原体。临床表现提示肺部急性移植物抗宿主病。其他地方没有疾病。因此，患者接受类固醇和他克莫司治疗。甲基强的松龙治疗12小时后，患者症状消失，影像学检查最终消退。肺急性移植物抗宿主病是干细胞移植后非常罕见的并发症，但对于移植物抗宿主病高风险或在停止免疫抑制后不久出现症状的患者应予以考虑。其诊断需要进行检查以排除感染性病因，并进行活检以确认组织学。Am. J. Hematol. 79：132-135，2005.© 2005 Wiley‐利斯公司
Acute graft‐versus‐host disease is a common complication after allogeneic stem cell transplantation. It normally affects the skin, liver, and gut. We report a 54‐year‐old male who developed shortness of breath, cough, and bilateral pulmonary infiltrates in which the work‐up failed to demonstrate an infectious etiology 165 days post‐HLA‐matched allogeneic peripheral blood stem cell transplant. Eighteen days before, his tacrolimus had been tapered and it was subtherapeutic on admission. A transbronchial biopsy showed a perivascular and interstitial lymphocytic infiltrate without evident pathogens on histology or extensive work‐up. The clinical picture was suggestive of pulmonary acute graft‐versus‐host disease. No disease was present elsewhere. Accordingly, the patient was treated with steroids and tacrolimus. After 12 hr on methylprednisolone, his symptoms disappeared with eventual resolution radiologically. Acute graft‐versus‐host disease of the lung is a very uncommon complication after stem cell transplant, but it should be considered in patients who are at high risk for graft‐versus‐host disease or developing symptoms soon after discontinuing immunosuppression. Its diagnosis requires work‐up to rule out an infectious etiology and a biopsy to confirm histology. Am. J. Hematol. 79:132–135, 2005. © 2005 Wiley‐Liss, Inc.
影响因子：
158.5
作者：
SANTOS, GW;TUTSCHKA, PJ;YEAGER, AM
通讯作者：
YEAGER, AM