Strasbourg Lung Transplant Program, University Hospital, Strasbourg, France.
Strasbourg Lung Transplant Program, University Hospital, Strasbourg, France; Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France; Institut National de la Santé et de la Recherche Médicale-Université de Strasbourg, Unité Mixte de Recherche 1260 Regenerative Ranomedecine, Strasbourg, France.
Transplant Proc. 2021 May;53(4):1371-1374. doi: 10.1016/j.transproceed.2021.03.020. Epub 2021 Apr 23.
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but serious dermatologic diseases. They can be associated with systemic manifestations such as bronchiolitis obliterans syndrome (BOS). SJS/TEN-induced BOS is associated with a poor prognosis, and no guidelines exist regarding its management. Several case reports have described the association between SJS/TEN and BOS, with few patients undergoing lung transplantation as a last resort therapy. Unfortunately, in the published reports, none of the transplanted patients were observed for a long period of time after the transplantation; therefore, the long-term mortality as well as the risk of recurrence of BOS could not be inferred from these reports.
We present the case of a young patient diagnosed with SJS complicated by BOS and end-stage respiratory failure refractory to corticosteroid therapy. She underwent bilateral lung transplantation with an outstanding outcome at 5-year follow-up.
SJS/TEN-induced BOS might have a favorable evolution and long-term outcomes following lung transplantation. However, prospective studies are needed to confirm this finding.
史蒂文斯-约翰逊综合征(SJS)和中毒性表皮坏死松解症(TEN)是罕见但严重的皮肤疾病。它们可能与支气管闭塞性细支气管炎综合征(BOS)等全身表现有关。SJS/TEN 引起的 BOS 预后较差,目前尚无关于其治疗的指南。已有几例病例报告描述了 SJS/TEN 与 BOS 之间的关联,少数患者最终接受肺移植作为治疗手段。不幸的是,在已发表的报告中,没有一例移植患者在移植后接受了长时间的观察;因此,无法从这些报告中推断出长期死亡率以及 BOS 复发的风险。
我们报告了一例年轻患者,被诊断为 SJS 合并 BOS 和对皮质类固醇治疗难治的终末期呼吸衰竭。她接受了双侧肺移植,在 5 年随访时取得了出色的结果。
SJS/TEN 引起的 BOS 可能在肺移植后具有良好的演变和长期结局。然而,需要前瞻性研究来证实这一发现。