Alteplase treatment for massive lung atelectasis in a child with severe bronchiolitis obliterans complicating Stevens‐Johnson syndrome

Romagnoli, V.; Amici, Mirco; Amici, Lucia; Gasparini, Stefano; Cazzato, Salvatore

doi:10.1002/ppul.24793

Cited by 1 publication

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“…At the early stage of SJS/TEN, bronchoscopy examination showed ulceration and exudative lesions with mucosal detachment in the whole respiratory tract (16). Bronchoscopy of other published cases showed occlusion of the bronchus, no endobronchial lesions, normal main and segmental airways, ulceration at the base of insertion of the endotracheal, and intense mucosal inflammation of airways (11,12,14,(22)(23)(24)26). Our patient did not complete a bronchoscopy examination, this is a limitation of this case.…”

Section: Discussionmentioning

confidence: 60%

Bronchiolitis obliterans associated with toxic epidermal necrolysis induced by infection: A case report and literature review

et al. 2023

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BackgroundStevens-Johnson syndrome/toxic epidermal necrolysis has a severe impact on patients' eyes, genital mucosa, and many other organs. Bronchiolitis obliterans is a rare complication of Stevens-Johnson syndrome/toxic epidermal necrolysis.Data sourcesWe report a case of bronchiolitis obliterans associated with toxic epidermal necrolysis in our department. Furthermore, we examined the patients with bronchiolitis obliterans induced by Stevens-Johnson syndrome/toxic epidermal necrolysis and summarized the clinical characteristics, treatment, and prognosis. Databases available online in English including PubMed, Medline, and Web of Science were consulted.ResultsWe report one case and review 23 published case reports. Of the 24 patients, 13 were female, the oldest patient was 59 years old and the youngest was 5 years old. The time of bronchiolitis obliterans onset after Stevens-Johnson syndrome/toxic epidermal necrolysis varied from 5 days to 5 months. Bronchoscopy examination showed ulceration, exudative lesions, occlusion, and inflammation. The CT of lung manifestation included mosaic perfusion, bronchiectasis, consolidation, air trapping, pneumatocele, pleural thickening, lung collapse, larger central airway dilatation, lung overinflation, oligemia, and pneumomediastinum. Most cases indicated pulmonary function tests with obstructive ventilation dysfunction. The prognosis was poor; six of the patients died.ConclusionsPatients with Stevens-Johnson syndrome/toxic epidermal necrolysis may develop bronchitis obliterans at different stages, so all patients with Stevens-Johnson syndrome/toxic epidermal necrolysis should be followed up for possible respiratory complications.

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