BRONCHIOLITIS OBLITERANS ORGANIZING PNEUMONIA AND ULCERATIVE-COLITIS AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION

A 37-year-old man with acute myeloblastic leukemia in first remission developed ulcerative colitis and bronchiolitis obliterans organizing p neumonia (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 conte xt of severe ulcerative colitis. Lung and colon biopsies showed no sig ns of CMV infection or GVHD. The patient was treated with oral methylp rednisolone 1 mg/kg/day and his clinical status and chest X-ray improv ed slowly. Remarkably, the symptoms of colitis also resolved with pred nisone therapy and he is now symptom-free. We hypothesize that ulcerat ive colitis may have been transmitted from donor to recipient (adoptiv e autoimmunity) and that it was complicated by BOOP. However, other fa ctors such as CMV may have contributed to the occurrence of BOOP.