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Recurrence of diffuse panbronchiolitis after lung transplantation
M A Baz1, P S Kussin, P Van Trigt
1Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710.
Summary
Diffuse panbronchiolitis (DBP) is a chronic respiratory inflammation typically seen in Asian populations. This case highlights DBP recurrence in an African American lung transplant recipient, suggesting a systemic cause.
Area of Science:
- Pulmonology and Transplant Medicine
- Immunology and Infectious Diseases
Background:
- Diffuse panbronchiolitis (DBP) is a chronic inflammatory airway disease predominantly affecting East Asian populations.
- Lung transplantation is a treatment option for end-stage lung disease, but allograft recipients are susceptible to disease recurrence.
Observation:
- A case of DBP is reported in an African American patient post-bilateral sequential lung transplantation.
- DBP recurred in the lung allograft 10 weeks after transplantation, leading to rapid graft dysfunction.
Findings:
- Treatment with erythromycin led to improved allograft function within weeks.
- The early recurrence and response to antibiotics suggest a systemic etiology for DBP.
Implications:
- This case broadens the known demographic profile of DBP.
- Early DBP recurrence post-transplant can cause significant allograft dysfunction, emphasizing the need for prompt diagnosis and management.
- The findings support the hypothesis of a systemic underlying cause for DBP, potentially influenced by factors beyond ethnicity.