Myelodysplastic syndrome (MDS) is frequently accompanied by systemic inflammatory disorders, including vasculitis. However, histopathologically confirmed pulmonary vasculitis is rare. We herein report the case of a man in his 50s with MDS, who presented with fever, pulmonary infiltrates, and persistent inflammation that was unresponsive to antibiotics. Transbronchial lung biopsy (TBLB) revealed leukocytoclastic vasculitis of the small pulmonary vessels, thus confirming the diagnosis. The pulmonary lesions resolved spontaneously without corticosteroid therapy. This case suggests that pulmonary vasculitis may contribute to the development of noninfectious pulmonary complications in MDS and that TBLB, despite its limitations, can occasionally provide histopathological confirmation.
Ozawa et al. (Thu,) studied this question.