Widespread pulmonary fibrosis as a major clinical manifestation of chronic graft-versus-host disease

K. Atkinson, D. Bryant, W. Delprado, J. Biggs

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)

Abstract

A 20-year-old Chinese male given an HLA-identical sibling bone marrow transplant for severe aplastic anemia, who had previously had chronic graft-versus-host disease (GVHD) of the mouth, developed myasthenia gravis and widespread pulmonary infiltrates with cough and exertional dyspnea at day 820 post-transplant. There was nothing to suggest aspiration pneumonia. Lung histology at day 940 showed some areas of dense pulmonary fibrosis, some areas of normal parenchyma, and some areas of widening of the interstitium and a mild lymphocytic infiltrate. Evidence of infection was not found. Treatment with cyclosporin and prednisone resulted in slow partial resolution of the infiltrates over 5 months. The myasthenia gravis was controlled with pyridostigmine. In view of the association with myasthenia gravis, of the absence of infectious agents and the response to immunosuppression, we conclude that widespread pulmonary fibrosis can be a major clinical manifestation of chronic GVHD. Examination of lung tissue to distinguish this from infective interstitial pneumonitis is essential.

Original languageEnglish
Pages (from-to)129-132
Number of pages4
JournalBone Marrow Transplantation
Volume4
Issue number1
Publication statusPublished - 1989
Externally publishedYes

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