A case of idiopathic interstitial pneumonia and pneumomediastinum in an allogeneic bone marrow transplant recipient of chronic myelogeneous leukemia

A patient with chronic myelogeneous leukemia received allogeneic bone marrow transplantation from HLA-identical sibling with a preparative regimen consisting of CY and TBI. The hematological recovery after BMT was prompt and acute GVHD was of minimum grade. The patient complicated interstitial pneumonia (IP) on day 112 after BMT. Repeated examination for the infectious causes were negative and chronic GVHD was not observed. Idiopathic interstitial pneumonia was unresponsive to repeated courses of bolus methylpredonisolone pulse therapy. The patient was managed later under the artifical respiration and complicated with pneumomediastinum. Thoracoscopic lung biopsy revealed diffuse, alveolar epithelial damage and fibrosis of the alveolar septum. The cause of interstitial pneumonia was unknown. Pneumomediastinum improved by drainage, but interstitial pneumonia progressed and the patient died on day 160 after BMT.

慢性骨髄性白血病

同種骨髄移植

特発性間質性肺炎

縦隔気腫

本文データは山口大学医学会の許諾に基づきCiNiiから複製したものである