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A fast and fatal course of bronchiectasis: an unusual rare expression of chronic
graft versus host disease A case report
#MMPMID28356792
Lab?entyt? V
; Zemnickien? S
; Danila E
; ?ileikien? V
; Zablockis R
; Gruslys V
Acta Med Litu
2016[]; 23
(1
): 54-59
PMID28356792
show ga
Introduction. We report a case of a patient with acute myeloid leukaemia whose
treatment with bone marrow transplantation (BMT) was followed by chronic graft
versus host disease (GVHD) with lung involvement and bronchiectasis. This report
illustrates an unusual course of a fast progression of the bronchiectasis due to
BMT. Case description. A 33-year-old female was diagnosed with acute myeloid
leukaemia. An allogeneic BMT was performed. One month after the transplantation,
acute GVHD with skin involvement occurred. Treatment with prednisolone and
mycophenolate mofetil (MMF) has been started. Nine months later, the patient was
examined by a pulmonologist due to progressive dyspnoea. A pulmonary computed
tomography (CT) scan showed normal parenchyma of the lungs and no changes to the
bronchi. A CT scan performed 7 months later revealed bronchiectasis for the first
time. No clinical response was associated with the treatment and the patient's
respiratory status progressively deteriorated. During the final hospitalization,
a CT scan performed 1 year later revealed huge cystic bronchiectasis in both
lungs. Despite the prophylaxis and treatment of GVHD and aggressive antimicrobial
therapy, the patient died one year after the diagnosis of bronchiectasis.
Conclusions. This case demonstrates that a fast and fatal course of
bronchiectasis, that occurs after BMT, should always be considered as a possible
manifestation of chronic graft versus host disease (cGVHD) following allogeneic
BMT.