Stevens-Johnson syndrome and toxic epidermal necrolysis: follow-up of pulmonary function after remission
| Autor: | Tu Anh Duong, N. de Prost, Saskia Ingen-Housz-Oro, Bernard Maitre, Martine Bagot, A.-S. Carrié, Laurence Valeyrie-Allanore, Pierre Wolkenstein, Olivier Chosidow, J.-C. Roujeau, F. Zerah |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Partial Pressure Vital Capacity Dermatology Asymptomatic Gastroenterology Pulmonary function testing Diffusion Young Adult DLCO Interquartile range Internal medicine Forced Expiratory Volume Medicine Humans Lung volumes Aged Body surface area Carbon Monoxide business.industry Total Lung Capacity respiratory system Airway obstruction Middle Aged medicine.disease Respiration Disorders Toxic epidermal necrolysis Surgery Oxygen Stevens-Johnson Syndrome Female medicine.symptom business Follow-Up Studies |
| Zdroj: | The British journal of dermatology. 172(2) |
| ISSN: | 1365-2133 |
| Popis: | Summary Background Acute-stage specific bronchial epithelial detachment has been described in 27% of patients with Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Objectives 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. |
| Databáze: | OpenAIRE |
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