Improvement in bronchiolitis obliterans organizing pneumonia in a child after allogeneic bone marrow transplantation by a combination of oral prednisolone and low dose erythromycin

We report a 13-year-old boy who developed dyspnea at rest 1 year after the occurrence of cGVHD following an allogeneic bone marrow transplant (BMT), P ulmonary function data, imaging studies, lung biopsy, and bronchoalveolar l avage were consistent with the diagnosis of bronchiolitis obliterans organi zing pneumonia (BOOP), Although reports suggest that oral methylprednisolon e or methylprednisolone pulse therapies improve BOOP after BMT, we treated our patient with a combination of oral prednisolone (1 mg/kg) and low dose erythromycin (10 mg/kg) to avoid the side-effects of high-dose steroids. Wi th this therapy, our patient showed clinical and radiological improvements within 1 week, The steroids were tapered off 12 months later and erythromyc in was given for 14 months, We conclude that therapy consisting of a combin ation of oral prednisolone and low-dose erythromycin for BOOP after BMT may minimize the dose and duration of steroid use.