A case of bronchiolitis obliterans after living-donor renal transplantation

Respir Investig. 2021 May;59(3):367-371. doi: 10.1016/j.resinv.2020.12.003. Epub 2021 Jan 29.

Abstract

We herein report the case of a 20 year-old-man who developed bronchiolitis obliterans after living-donor renal transplantation. The patient presented with dyspnea on exertion and wheezing two years after renal transplantation, and spirometry showed an obstructive pattern. Surgical lung biopsy revealed subepithelial fibrosis that constricted and obstructed the intrabronchiolar space. Based on these findings, the patient was diagnosed with bronchiolitis obliterans. He was prescribed bronchodilators and azithromycin, and he achieved stable respiratory function for two years. The differential diagnosis of respiratory symptoms after renal transplantation includes opportunistic infection and drug-induced lung injury; however, bronchiolitis obliterans should also be considered.

Keywords: Acute rejection; Bronchiolitis obliterans; Graft versus host disease; Living-donor renal transplantation; Obstructive lung diseases.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Azithromycin / therapeutic use
  • Bronchiolitis Obliterans / diagnosis*
  • Bronchiolitis Obliterans / drug therapy
  • Bronchiolitis Obliterans / etiology*
  • Bronchiolitis Obliterans / pathology
  • Bronchodilator Agents / therapeutic use
  • Diagnosis, Differential
  • Fibrosis
  • Humans
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / methods*
  • Living Donors*
  • Lung / pathology
  • Lung / physiopathology
  • Male
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology*
  • Postoperative Complications / pathology
  • Spirometry
  • Young Adult

Substances

  • Bronchodilator Agents
  • Azithromycin