[en] A 37-year-old man with acute myeloblastic leukemia in first remission developed ulcerative colitis and bronchiolitis obliterans organizing pneumonia (BOOP) 7 months after bone marrow transplantation (BMT) from an HLA-matched brother who suffered from severe Crohn's disease. BOOP occurred 20 days after idiopathic interstitial pneumonia, in the context of severe ulcerative colitis. Lung and colon biopsies showed no signs of CMV infection or GVHD. The patient was treated with oral methylprednisolone 1 mg/kg/day and his clinical status and chest X-ray improved slowly. Remarkably, the symptoms of colitis also resolved with prednisone therapy and he is now symptom-free. We hypothesize that ulcerative colitis may have been transmitted from donor to recipient (adoptive autoimmunity) and that it was complicated by BOOP. However, other factors such as CMV may have contributed to the occurrence of BOOP.
Disciplines :
Hematology
Author, co-author :
Baron, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Hermanne, Jean-Philippe; Centre Hospitalier Universitaire de Liège - CHU
Dowlati, A.
Weber, T.
Thiry, Albert ; Université de Liège - ULiège > Anatomie pathologique
Fassotte, Marie-France ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Fillet, Georges ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Beguin, Yves ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie clinique
Language :
English
Title :
Bronchiolitis obliterans organizing pneumonia and ulcerative colitis after allogeneic bone marrow transplantation.
Chien J, Chan CK, Chamberlain D et al. Cytomegalovirus pneumonia in allogeneic bone marrow transplantation, an immunopathologic process? Chest 1990; 98: 1034-1037.
Thirman MJ, Devine SM, O'Toole K et al. Bronchiolitis obliterans organizing pneumonia as a complication of allogeneic bone marrow transplantation. Bone Marrow Transplant 1992; 10: 307-311.
Mathew P, Bozeman P, Krance RA et al. Bronchiolitis obliterans organizing pneumonia (BOOP) in children after allogeneic bone marrow transplantation. Bone Marrow Transplant 1994; 13: 221-223.
Przepiorka D, Abu-Elmagd K, Huaringa A et al. Bronchiolitis obliterans organizing pneumonia in a BMT patient receiving FK506. Bone Marrow Transplant 1993; 11: 502.
McDonald GB, Shulman HM, Sullivan KM, Spencer GD. Intestinal and hepatic complications of bone marrow transplantation. Gastroenterology 1986; 90: 770-784.
Marmont AM. Autoimmunity and allogeneic bone marrow transplantation. Bone Marrow Transplant 1992; 9: 1-3.
Nelson JL, Torrez R, Louie FM et al. Pre-existing auto-immune disease in patients with long-term survival after allogeneic bone marrow transplantation. J Rheumatol 1997; 24 (Suppl. 48): 23-29.
Marmont AM. Stem cell transplantation for severe auto-immune disorders, with special reference to rheumatic diseases. J Rheumatol 1997; 24 (Suppl. 48): 13-18.
Tyndall A. Hematopoietic stem cell transplantation in rheumatic diseases other than systemic sclerosis and systemic lupus erythematosus. J Rheumatol 1997; 24 (Suppl. 48): 94-97.
Spiers AS. Ulcerative colitis after bone marrow transplantation for acute leukemia. New Engl J Med 1984; 311: 1259.
Stenson WF, MacDermott RP. Inflammatory bowel disease. In: Yamada T, Alpers DH, Owyang C et al (eds). Textbook of Gastroenterology. JB Lippincott: Philadelphia, 1991, pp 1588-1645.
