Severe airflow obstruction and eosinophilic lung disease after Stevens-Johnson syndrome

Shah, Alpa P.; Xu, Hongmin; Sime, Patricia J.; Trawick, David R.

doi:10.1183/09031936.00036006

Cited by 16 publications

(11 citation statements)

References 21 publications

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“…In survivors, late pulmonary sequelae, including interstitial lung disease, respiratory tract obstruction, bronchiectasis, bronchitis and bronchiolitis obliterans (BO), have all been observed, with the latter being the most commonly reported (Table ) . BO is a consequence of airway epithelial injury with subsequent epithelial regeneration and scarring.…”

Section: Pulmonary Sequelaementioning

confidence: 99%

Long-term complications of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN): the spectrum of chronic problems in patients who survive an episode of SJS/TEN necessitates multidisciplinary follow-up

2017

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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe adverse reactions to drugs that cause a life-threatening eruption of mucocutaneous blistering and epithelial sloughing. While the acute complications of SJS/TEN are well described, it is increasingly recognized that survivors may develop delayed sequelae, some of which can be associated with significant morbidity. Studies of long-term SJS/TEN outcomes mostly focus on mucocutaneous and ocular complications. However, other internal organs, such as the respiratory tract and gastrointestinal tract, can be affected. Psychological sequelae are also frequent following the trauma of widespread epidermal necrolysis. An appreciation of the 'chronic' phase of SJS/TEN is needed by clinicians caring for individuals who have survived the acute illness. This review aims to provide an update on the breadth and range of sequelae that can affect patients in the months and years following an acute episode of SJS/TEN.

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Section: Pulmonary Sequelaementioning

confidence: 99%

Long-term complications of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN): the spectrum of chronic problems in patients who survive an episode of SJS/TEN necessitates multidisciplinary follow-up

2017

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“…Chronic pulmonary complications resulting from TEN and SJS are rare. According to previous studies published in English, 22 patients who suffered from chronic pulmonary diseases following TEN/SJS were identified, including the present case (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). The age of patients ranged between 2 and 52 years, and there were 10 male and 12 female patients (Table I).…”

Section: Discussionmentioning

confidence: 94%

Chronic pulmonary complications associated with toxic epidermal necrolysis: A case report and literature review

Chen

et al. 2018

Exp Ther Med

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Patients with toxic epidermal necrolysis (TEN) are known to experience various complications. Although pulmonary complications are commonly observed, they typically manifest in an acute form. By contrast, chronic complications are quite rare, and little is known with regard to their incidences or clinical manifestations. The present study reports the case of a 29-year-old female patient who suffered from TEN. At the onset of the disease, the patient exhibited no pulmonary impairment; however, 1 month after recovering from TEN, the patient developed severe obstruction and a mild diffusion defect. A diagnosis of bronchiolitis obliterans was determined, and the patient was treated with antibiotics, inhaled corticosteroids, anticholinergic agents, and bronchodilators. At the last follow-up, the patient was alive, but with a stable airway obstruction.

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“…Finally, production of growth factors such as TGF-β which promote fibroblast proliferation may result in fibrosis at late phase of BO formation. In addition, Shah et al [8] reported that a case of constrictive BO and eosinophilic micro-abscesses after SJS. It is known that eosinophils are important sources of a variety of pro-fibrogenic mediators such as TGF-α [12], TGF-β [13], vascular endothelial growth factor [14], and interleukin-13 [15].…”

Section: Discussionmentioning

confidence: 99%

Bronchiolitis obliterans associated with Stevens-Johnson Syndrome: histopathological bronchial reconstruction of the whole lung and immunohistochemical study

Sugino

Hebisawa

Uekusa³

et al. 2013

Diagn Pathol

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This study presents an extremely rare case of constrictive bronchiolitis obliterans (BO) associated with Stevens-Johnson Syndrome (SJS) provides the morphological and immunohistochemical features using histopathological bronchial reconstruction technique. A 27-year-old female developed progressive dyspnea after SJS induced by taking amoxicillin at the age of 10. Finally, she died of exacerbation of type II respiratory failure after 17 years from clinically diagnosed as having BO. Macroscopic bronchial reconstruction of the whole lungs at autopsy showed the beginning of bronchial obliterations was in the 4th to 5th branches, numbering from each segmental bronchus. Once they were obliterated, the distal and proximal bronchi were dilated. Microscopic bronchial reconstruction demonstrated the localization of obliteration was mainly from small bronchi to membranous bronchioli with intermittent airway luminal narrowing or obliteration. Moreover, CD3-, CD20-, and CD68-positive cells were found in the BO lesions. CD34- and D2-40-positive cells were mainly distributed in the peribronchiolar lesions and bronchiolar lumens, respectively. SMA- and TGF-β-positive cells were seen in the fibrous tissue of BO lesions.The virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1071703140102601.

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Severe airflow obstruction and eosinophilic lung disease after Stevens-Johnson syndrome

Cited by 16 publications

References 21 publications

Long-term complications of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN): the spectrum of chronic problems in patients who survive an episode of SJS/TEN necessitates multidisciplinary follow-up

Long-term complications of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN): the spectrum of chronic problems in patients who survive an episode of SJS/TEN necessitates multidisciplinary follow-up

Chronic pulmonary complications associated with toxic epidermal necrolysis: A case report and literature review

Bronchiolitis obliterans associated with Stevens-Johnson Syndrome: histopathological bronchial reconstruction of the whole lung and immunohistochemical study

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