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Case 281: Thoracic Air Leak Syndrome in a Patient with Hematopoietic Stem Cell Transplantation and Graft-versus-Host
Amin Pastaki Khoshbin1, Rasoul Aliannejad1
1From the School of Medicine (A.P.K.) and Department of Respiratory and Critical Care Medicine, Shariati Hospital (R.A.), Tehran University of Medical Sciences, Karegar Street North, Tehran, Iran 1416753955; and Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran (R.A.).
Abstract:
HistoryAn 18-year-old man was diagnosed with precursor B-cell lymphoblastic leukemia and underwent transplantation of hematopoietic stem cells from his human leukocyte antigen-matched sister 1 year prior to admission. He was admitted to evaluate progressive shortness of breath and dry cough of 1-month duration. He did not report fever, night sweats, or hemoptysis. Physical examination revealed he was afebrile and had normal pulse oxygen saturation. The examination revealed crepitation on palpation of the anterior neck, expiratory wheezes, and crackles heard at auscultation of bases of both lungs. Extensive maculopapular rash on the skin was consistent with graft-versus-host disease (GVHD). Laboratory tests revealed elevated liver transaminase and bilirubin levels that were attributed to liver GVHD. Nonenhanced thin-section CT of the chest was performed.
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