Severe airflow obstruction and eosinophilic lung disease after Stevens-Johnson syndrome.
Respiratory involvement is a frequent complication of Stevens-Johnson syndrome (SJS). However, there are very few convincing reports of persistent pulmonary sequelae, as demonstrated by spirometry, radiology and pathology. The current study presents a case of a 13-yr-old female with T-cell acute lymphocytic leukaemia who developed persistent, severe, obstructive lung disease following an episode of SJS. A lung biopsy demonstrated bronchiolar submucosal fibrosis consistent with constrictive bronchiolitis, as well as eosinophilic micro-abscesses, which, to the current authors' knowledge, has not been previously described. The present study illustrates specific histopathological features that highlight a possible association between Stevens-Johnson syndrome, constrictive bronchiolitis and eosinophilic micro-abscesses. The eosinophils may be associated with permanent mucosal damage, as seen in the present case, by releasing mediators that have a pro-fibrogenetic role. However, further investigation is warranted.
Shah
A P
AP
Department of Medicine, Pulmonary and Critical Care Unit, University of Rochester Medical Center, Rochester, NY, USA. alpashah@hotmail.com
Xu
H
H
Sime
P J
PJ
Trawick
D R
DR
D000293:Adolescent; D000402:Airway Obstruction / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D011657:Pulmonary Eosinophilia / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D012129:Respiratory Function Tests; D013262:Stevens-Johnson Syndrome / Q000150:complications* / Q000628:therapy