Pulmonary restriction secondary to cutaneous sclerosis caused by chronic graft versus host disease: Case Report
DOI:
https://doi.org/10.31053/1853.0605.v76.n3.21090Keywords:
lung diseases, graft-versus-host disease, bone marrow transplantation, respiratory function tests.Abstract
Chronic graft versus host disease (GVHD) is a major complication of the allogeneic stem cell transplant. One of most frequent manifestations of GVHD is the cutaneous compromise with the sclerodermatous variety being the most severe. We considered that the restrictive respiratory compromise and its evolution are not well characterized. We described the functional respiratory alterations of a patient with sclerodermatous chronic GVHD and considered differential diagnosis of pulmonary restriction in this type of patient. We reported the case of a 21-year-old woman with pulmonary restriction secondary to cutaneous sclerosis which was caused by chronic GVHD. This report illustrates the importance of utilizing both functional respiratory tests and diagnosis images to accurately characterize the cause of the respiratory compromise. We believe that the functional alterations described in this case could be caused by the cutaneous disorder found.
Downloads
References
Copelan EA. Hematopoietic stem-cell transplantation. N Engl J Med. 2006;354(17):1813-1826.
Flowers M, Parker PM, Johnston LJ, Matos AV, Storer B, Bensinger W, Storb R, et al. Comparison of chronic graft-versus-host disease after transplantation of peripheral blood stem cells versus bone marrow in allogeneic recipients: long-term follow-up of a randomized trial. Blood. 2002;100(2):415-419.
Martires KJ, Baird K, Steinberg SM, Grkovic L, Galen OJ, Kirsten MW, et al. Sclerotic-type chronic GVHD of the skin: clinical risk factors, laboratory markers, and burden of disease. Blood. 2011;118(15):4250-4257.
Skert C, Patriarca F, Sperotto A, et al. Sclerodermatous chronic graft-versus-host disease after allogeneic hematopoietic stem cell transplantation: Incidence, predictors and outcome. Haematologica. 2006;91(2):258-261.
Hildebrandt GC, Fazekas T, Lawitschka A, et al. Diagnosis and treatment of pulmonary chronic GVHD: report from the consensus conference on clinical practice in chronic GVHD. Bone Marrow Transplant. 2011;46(10):1283-1295.
Bhalla KS, Wilczynski SW, Abushamaa AM, et al. Pulmonary toxicity of induction chemotherapy prior to standard or high-dose chemotherapy with autologous hematopoietic support. Am J Respir Crit Care Med. 2000;161(1):17-25.
Movsas B, Raffin TA, Epstein AH, Link CJ. Pulmonary radiation injury. Chest. 1997;111(4):1061-1076.
Freudenberger TD, Madtes DK, Curtis JR, Cummings P, Storer BE, Hackman RC. Association between acute and chronic graft-versus-host disease and bronchiolitis obliterans organizing pneumonia in recipients of hematopoietic stem cell transplants. Blood. 2003;102(10):3822-3828.
Panoskaltsis-Mortari A, Griese M, Madtes DK, et al. An official American Thoracic Society research statement: noninfectious lung injury after hematopoietic stem cell transplantation: idiopathic pneumonia syndrome. Am J Respir Crit Care Med. 2011;183(9):1262-1279.
Chien J, Duncan S. Bronchiolitis obliterans syndrome after allogeneic hematopoietic stem cell transplantation—an increasingly recognized manifestation of chronic graft-versus-host. Biol Blood Marrow Transpl. 2010;16(1):1-16
Evans JA, Whitelaw WA. The Assessment of Maximal Respiratory Mouth Pressures In Adults. Respir Care. 2009;54(10):1348-1359.
Savani BN, Montero A, Srinivasan R, et al. Chronic GVHD and Pretransplantation Abnormalities in Pulmonary Function Are the Main Determinants Predicting Worsening Pulmonary Function in Long-term Survivors after Stem Cell Transplantation. Biol Blood Marrow Transplant. 2006;12(12):1261-1269.
Walter E, Orozco-Levi M. Lung function and long-term complications after allogeneic hematopoietic cell transplant. Biol Blood Marrow Transpl. 2010;16(1):53-61.
Barker AF, Bergeron A, Rom WN, Hertz MI. Obliterative bronchiolitis. N Engl J Med. 2014;370(19):1820-1828.
Vanderschueren D, Decramer M, Van den Daele P, Dequeker J. Pulmonary function and maximal transrespiratory pressures in ankylosing spondylitis. Ann Rheum Dis. 1989;48(8):632-635.
Braun NM, Arora NS, Rochester DF. Respiratory muscle and pulmonary function in polymyositis and other proximal myopathies. Thorax. 1983;38(8):616-623.
Johnson D. Importance of adjusting carbon monoxide diffusing capacity (DLCO) and carbon monoxide transfer coefficient (KCO) for alveolar volume. Respir Med. 2000;94(1):28-37.
Additional Files
Published
How to Cite
Issue
Section
License
The Faculty of Medical Sciences Journal (RFCM) subscribes to the Open Access policy and does not charge authors fees for publishing, nor does it charge readers fees for accessing published articles (APC).