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Park, Ok, Kim, Kim, Park, An, Kim, Jeong, Kim, Lee, Lee, Kang, Kim, Kim, Kim, Kim, and Song: A Case of Acute Eosinophilic Pneumonia after Hematopoietic Stem Cell Transplantation
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2011; 71(6): 459-463.

Published online: 29 December 2011

DOI: https://doi.org/10.4046/trd.2011.71.6.459

A Case of Acute Eosinophilic Pneumonia after Hematopoietic Stem Cell Transplantation

Hwan Sung Park, M.D.1, Tae Jin Ok, M.D.1, You Jae Kim, M.D.1, Guang Un Kim, M.D.1, Soeun Park, M.D.1, Jihyun An, M.D.1, Yun Ku Kim, M.D.1, Jae Ho Jeong, M.D.1, Su-Jeong Kim, M.D.1, Yumi Lee, M.D.1, Ho-Su Lee, M.D.1, Bo Hyoung Kang, M.D.1, Ga Hee Kim, M.D.1, Dae-Young Kim, M.D.2, Woo Sung Kim, M.D.3, Dong Soon Kim, M.D.3, Jin Woo Song, M.D.3

1Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

2Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

3Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Address for correspondence: Jin Woo Song, M.D. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea. Phone: 82-2-3010-3993, Fax: 82-2-3010-6968, skysong3@hanmail.net

Received 31 May 2011       Accepted 22 July 2011

Copyright © 2011. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Pulmonary complications occur in 40~60% of patients who receive hematopoietic stem cell transplantation (HSCT) and are a source of substantial morbidity and mortality. Acute eosinophilic pneumonia (AEP) is an uncommon, non-infectious pulmonary complication occurring in HSCT recipients. We now report the case of a 52-year-old man with AEP who was treated with allogenic HSCT due to acute myeloid leukemia. He complained of fever, cough and dyspnea 390 days after allogenic HSCT. He also had skin and hepatic graft versus host disease (GVHD). Hypoxemia, diffuse pulmonary infiltrates on a chest x-ray and eosinophilia in bronchoalveolar lavage fluid were also noted in several tests. His symptoms, pulmonary infiltrates, hepatic dysfunction and skin lesions rapidly improved after treatment with corticosteroid therapy. Our case supports the idea that AEP is a late phase non-infectious pulmonary complication and one of the manifestations of chronic GVHD.

Keywords: Pulmonary Eosinophilia, Hematopoietic Stem Cell Transplantation, Graft vs Host Disease

Figures and Tables

Figure 1
Initial chest X-ray shows bilateral multifocal patchy infiltrates.
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Figure 2
(A, B) Chest CT scan shows multiple ground-glass opacities and subpleural nodular consolidations on both lung parenchyma. CT: computed tomography.
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Figure 3
Chest X-ray 5 days after steroid treatment shows rapid improvement of bilateral patchy infiltrates.
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Figure 4
Chest CT scan after 3 months shows improvement of infiltrations in both lungs. CT: computed tomography.
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