Multiple Pulmonary Complications in a Patient with Stevens-Johnson Syndrome

Abstract

Since first described in 1922, Stevens-Johnson syndrome has been associated frequently with pneumonia of many etiologies. This "mucosal respiratory syndrome," first reported by Stanyon and Warner in 1945, is associated with "early" pneumonia which resolves 2 to 3 weeks after onset of the rash. In our patient, pneumonia began 10 days after rash onset and was nearly resolved by day 20. The unique feature of this case was the onset of late pulmonary complications 25 days after the appearance of the exanthem, manifesting as acute noninfectious interstitial disease with superimposed airway obstruction.

Severe airflow obstruction in a patient with ulcerative colitis and toxic epidermal necrolysis: A case report

“…This inflammatory process is associated with numerous conditions, including UC (5-7), bullous skin disease (8), Stevens-Johnson syndrome (9)(10)(11)(12)(13)(14), graft versus host disease following a lung or bone marrow transplant (15)(16)(17)(18) and certain drugs (1,6). The current patient was a middle-aged ex-smoker who complained of sub-acutely developed exertional dyspnea.…”

Severe Obliterative Bronchitis Associated with Stevens-Johnson Syndrome

“…Fourteen cases of obliterative bronchitis or bronchiolitis following SJS/TEN have been reported (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Two cases were thought to result from SJS brought on by mycoplasma infections (11,12), and 11 cases were thought to have been related to SJS / TEN caused by drugs (13)(14)(15)(16)(17)(18)(19)(21)(22)(23). Six cases of severe respiratory failure, similar to that of the present patient, resulted in fatalities from 2 months to one and a half years after the onset of SJS/TEN (11,12,15,20,21,23).…”

“…One patient developed progressive respiratory failure due to obliterative bronchiolitis, and underwent a living-donor lung transplantation 6 months after the onset of SJS (22). The other patients were discharged, but they all had prolonged respiratory complaints (13,14,(16)(17)(18)(19). There are no reports of patients who have survived on mechanical ventilation due to obliterative bronchitis or bronchiolitis after SJS / TEN (11,12,15,20,21,23).…”

“…However, there are only a few reports concerning chronic pulmonary complications in patients with SJS/TEN (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). We herein report a patient with SJS who had been diagnosed with severe obliterative bronchitis and died due to respiratory failure.…”

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

“…Also, a strong temporal association existed between SJS and the development of obstructive lung disease in the patient. In most patients with SJS who develop pulmonary pathology, the appearance of signs and symptoms occurs within 2-4 weeks after the onset of SJS [1,11,12]. Conversely, CB associated with GVHD usually appears much later [13,14], and is usually a manifestation of late disease in GVHD patients.…”