title: Stevens-Johnson syndrome and toxic epidermal necrolysis: follow-up of pulmonary function after remission.
abstract: BACKGROUND
  Acute-stage specific bronchial epithelial detachment has been described in 27% of patients with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
  
  
  OBJECTIVE
  To assess the pulmonary function of patients with SJS/TEN after remission.
  
  
  METHODS
  Analysis of pulmonary function tests (PFTs) performed during the usual follow-up of patients with SJS/TEN managed in a referral centre from April 2007 to January 2010.
  
  
  RESULTS
  Of 58 patients admitted, 32 underwent PFTs (17 male, 15 female). The median time from the acute stage to PFTs was 3 months (interquartile range 1-18). Three patients had grade 2 dyspnoea. Eighteen patients (56%) had abnormal PFTs, including 13 patients (41%) with moderately altered diffusion capacity for carbon monoxide (DLCO ) normalized by the alveolar volume (VA) (giving the ratio KCO , which equals DLCO /VA) and five patients with decreased total lung capacity. No airway obstruction was observed. Patients with decreased KCO had higher initial detached body surface area than others (30% vs. 10%, P = 0·006), as did those with decreased DLCO (25% vs. 10%; P = 0·054). There were correlations between detached body surface area and both KCO (r = -0·41, P = 0·026) and DLCO (r = -0·47, P = 0·011). Among 10 patients with decreased KCO on the first PFT, eight patients had a sustained decrease in KCO on a second PFT.
  
  
  CONCLUSIONS
  More than half of patients with SJS/TEN displayed abnormalities on PFTs, mainly diffusion impairment, which was associated with higher initial skin surface detachment. These abnormalities were mostly asymptomatic and remained stable over time.
authors.affiliation: Service de Dermatologie, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, 51 Ave du Maréchal de Lattre de Tassigny, 94010, Créteil CEDEX, France; Centre de Référence de Dermatoses Bulleuses Toxiques, Créteil, France.
authors.forename: T A
authors.initials: TA
authors.lastname: Duong
authors.forename: N
authors.initials: N
authors.lastname: de Prost
authors.forename: S
authors.initials: S
authors.lastname: Ingen-Housz-Oro
authors.forename: A-S
authors.initials: AS
authors.lastname: Carrié
authors.forename: F
authors.initials: F
authors.lastname: Zerah
authors.forename: L
authors.initials: L
authors.lastname: Valeyrie-Allanore
authors.forename: M
authors.initials: M
authors.lastname: Bagot
authors.forename: O
authors.initials: O
authors.lastname: Chosidow
authors.forename: J-C
authors.initials: JC
authors.lastname: Roujeau
authors.forename: P
authors.initials: P
authors.lastname: Wolkenstein
authors.forename: B
authors.initials: B
authors.lastname: Maitre
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002248:Carbon Monoxide; D004058:Diffusion; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D012120:Respiration Disorders / Q000209:etiology / Q000503:physiopathology*; D013262:Stevens-Johnson Syndrome / Q000150:complications / Q000503:physiopathology*; D014109:Total Lung Capacity; D014797:Vital Capacity / Q000502:physiology; D055815:Young Adult
chemical_list: D002248:Carbon Monoxide; D010100:Oxygen