Pulmonary veno-occlusive disease, a rare but fatal complication among patients with hematologic malignancy

Authors

  • Nuanrat Cheerasiri -Division of Haematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
  • Krissana Panrong Division of Haematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital
  • Apirak Junpeng Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital
  • Noppacharn Uaprasert Division of Haematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital
  • Udomsak Bunworasate Division of Haematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital

Keywords:

pulmonary veno-occlusive disease, hematopoietic stem cell transplantation, alkylating agent

Abstract

Pulmonary veno-occlusive disease (PVOD), classified as group 1 pulmonary hypertension, is a rare but fatal form of pulmonary artery hypertension (PAH) manifesting subacute to chronic progressive dyspnea due to the increase in pulmonary arterial pressure and right-side heart failure. Exposure to chemotherapy and poststem cell transplantation constitute risk factors of PVOD. We herein demonstrate a case of PVOD in a middle-aged female with the underlying disease of T-cell/histiocyte-rich large B cell lymphoma treated using an alkylating agent and hematopoietic stem cell transplantation and presenting biventricular heart failure. After being treated using methylprednisolone, diuresis and pulmonary vasodilators, her clinical symptoms transiently improved. Unfortunately, the patient passed away one year after the diagnosis due to the progression of right-sided heart failure. Necropsy of the lung was performed revealing the occlusion of pulmonary venules.

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References

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Published

2023-06-22

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รายงานผู้ป่วย (Case report)