Bronchiolitis obliterans due to toxic epidermal necrolysis with structural evaluation using computed tomography bronchography: A case report

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL

Acute Medicine & Surgery Pub Date : 2025-04-14 DOI:10.1002/ams2.70046

Hidemasa Kudo, Ken Katsuta, Shigeki Kushimoto

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Abstract

Background

Toxic epidermal necrolysis (TEN) can lead to various extracutaneous complications, including respiratory involvement. We present a case of a patient who developed bronchiolitis obliterans (BO) after the acute phase of TEN, with computed tomography (CT) bronchography revealing bronchial tree structural changes.

Case Presentation

A 60-year-old woman presented with a rash and hoarseness 2 days after taking ibuprofen and was diagnosed with TEN. While her cutaneous symptoms improved by day 20, the flow-volume loop indicated obstructive respiratory failure. CT bronchography revealed bead-like changes and mural irregularities in the bronchi; thus, BO was diagnosed. Despite treatment with bronchodilators and steroids, she required long-term mechanical ventilation with persistent bronchial alterations.

Conclusion

Extracutaneous complications of TEN are crucial, particularly in BO development following the acute phase. In this case, CT bronchography showed treatment-refractory bead-like changes and mural irregularities in the bronchioles.

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中毒性表皮坏死松解所致闭塞性细支气管炎的计算机断层支气管造影结构评价：1例报告

背景中毒性表皮坏死溶解症（TEN）可导致各种皮肤外并发症，包括呼吸系统受累。我们报告了一例在 TEN 急性期后发展为阻塞性支气管炎（BO）的患者，其计算机断层扫描（CT）支气管造影显示支气管树结构发生了变化。病例介绍一位 60 岁的妇女在服用布洛芬 2 天后出现皮疹和声音嘶哑，被诊断为 TEN。虽然她的皮肤症状在第 20 天时有所改善，但血流-容积循环显示她出现了阻塞性呼吸衰竭。CT 支气管造影显示支气管内有珠状改变和壁状不规则，因此诊断为 BO。尽管使用了支气管扩张剂和类固醇治疗，她仍需要长期机械通气，支气管病变持续存在。结论 TEN 的皮肤外并发症至关重要，尤其是在急性期后出现 BO 时。在该病例中，CT 支气管造影显示了难治性珠状改变和支气管壁不规则。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acute Medicine & Surgery MEDICINE, GENERAL & INTERNAL-

自引率

12.50%

发文量

审稿时长

53 weeks