Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Nonclassifiable Interstitial Pneumonia after Allogeneic Hematopoietic Stem Cell Transplantation

동종 조혈모세포이식 후 비분류성 간질성 폐렴으로 사망한 1예

  • Jung, Ki Hwan (Department of Internal Medicine, Korea University Ansan Hospital) ;
  • Sung, Hwa Jung (Department of Internal Medicine, Korea University Ansan Hospital) ;
  • Lee, Ju-Han (Department of Pathology, Korea University Ansan Hospital) ;
  • Han, Jungho (Department of Pathology, Saumsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Shin, Chol (Department of Internal Medicine, Korea University Ansan Hospital) ;
  • Park, Hyung Joo (Department of Thoracic and Cardiovascular Surgery, Korea University Ansan Hospital) ;
  • Kim, Je Hyeong (Department of Internal Medicine, Korea University Ansan Hospital)
  • 정기환 (고려대학교 안산병원 내과) ;
  • 성화정 (고려대학교 안산병원 내과) ;
  • 이주한 (고려대학교 안산병원 병리과) ;
  • 한정호 (성균관대학교 의과대학 삼성서울병원 병리과) ;
  • 신철 (고려대학교 안산병원 내과) ;
  • 박형주 (고려대학교 안산병원 흉부외과) ;
  • 김제형 (고려대학교 안산병원 내과)
  • Received : 2008.12.23
  • Accepted : 2009.01.19
  • Published : 2009.02.28
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Abstract

Despite the improvements in supportive care, early and late hematopoietic stem cell transplantation-related complications still remain a significant cause of morbidity and mortality. Pulmonary complications occur in 40-60% of patients who undergo allogeneic hematopoietic stem cell transplantation. Late-onset noninfectious pulmonary complications can occur months and even years after transplantation. Interstital lung disease has also been reported to be a late post-transplant complication. Exposure to cytotoxic drugs and/or irradiation has been implicated as a cause of pulmonary toxicity including pulmonary fibrosis. We report a case of an 18-year-old female with non-classifiable interstitial pneumonia that manifested eight and a half years after allogeneic hematopoietic stem cell transplantation. The condition worsened rapidly and the patient eventually died.

조혈모세포이식 후 1년 이내에 발생하는 폐 합병증의 진단 및 분류는 확립되어 있으나, 수 년 이상 장기간 생존자에게서 발생하는 폐 합병증에 대해서는 잘 알려져 있지 않다. 저자들은 8년 전 동종 조혈모세포이식을 시행받고, 호흡곤란을 주소로 내원한 18세 여자 환자에서, 폐조직 생검을 통해 비분류성 간질성 폐렴을 진단하였으나, 스테로이드 치료에도 불구하고 급격한 악화를 보여 호흡부전으로 사망한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Keywords

References

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