Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Benesch, M; Kerbl, R; Schwinger, W; Lackner, H; Pfleger, A; Popper, H; Urban, C.
Discrepancy of clinical, radiographic and histopathologic findings in two children with chronic pulmonary graft-versus-host disease after HLA-identical sibling stem cell transplantation.
Bone Marrow Transplant. 1998; 22(8):809-812
Doi: 10.1038/sj.bmt.1701425
(- Case Report)
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- Führende Autor*innen der Med Uni Graz
- Benesch Martin
- Co-Autor*innen der Med Uni Graz
- Kerbl Reinhold
- Lackner Herwig
- Pfleger Andreas
- Popper Helmuth
- Schwinger Wolfgang
- Urban Ernst-Christian
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- Abstract:
- We report two children who presented with cough and shortness of breath 7-8 months after a matched sibling stem cell transplant (SCT) for chronic myelogenous leukemia and myelodysplastic syndrome, respectively. Pulmonary function tests (PFTs) revealed severe airways obstruction (AO). However, radiographic investigations showed no serious abnormalities in the early phase and open lung biopsy revealed only mild lymphocytic bronchiolitis and bronchiolitis obliterans consistent with pulmonary graft-versus-host disease (GVHD). Despite administration of bronchodilators and various immunosuppressive agents obstructive lung disease progressed to pulmonary failure in patient 1, whereas stabilization of the clinical course was observed in patient 2. Serial PFTs were the best predictor of the clinical course in contrast to radiographic and histologic findings. It is concluded that PFTs should be performed repeatedly in pediatric patients after allogeneic SCT with the aim of diagnosing GVHD-associated AO in the subclinical phase. Progressive post-transplant AO necessitates prompt initiation of intensive immunosuppressive therapy in order to stop the underlying immunopathologic process even in the absence of severe radiographic and histologic findings.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Chronic Disease -
- Female -
- Graft vs Host Disease - pathology
- Hematopoietic Stem Cell Transplantation - pathology
- Histocompatibility Testing - pathology
- Humans - pathology
- Leukemia, Myeloid, Chronic - therapy
- Lung Diseases - pathology
- Male - pathology
- Myelodysplastic Syndromes - therapy
- Transplantation, Homologous - therapy
- Find related publications in this database (Keywords)
- stem cell transplantation
- graft-versus-host disease
- airways obstruction
- immunosuppressive therapy