ISSN 1674-3865  CN 21-1569/R
主管:国家卫生和计划生育委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

Chinese Pediatrics of Integrated Traditional and Western Medicine ›› 2020, Vol. 12 ›› Issue (5): 413-417.doi: 10.3969/j.issn.1674-3865.2020.05.013

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Clinical analysis of 5 cases of StevensJohnson syndrome complicated with bronchiolitis obliterans and literature review

  

  • Online:2020-10-25 Published:2020-11-28

Abstract: The clinical features of 5 cases of StevensJohnson syndrome complicated with bronchiolitis obliterans(BO), chest CT, treatment and prognosis were analyzed.Three cases had a clear history of medication; 5 cases had cough and wheezing symptoms,4 of which had wet and dry murmurs before discharge, and had been followed up in the clinic after discharge. One patient developed cough and wheezing symptoms one week after discharge,and was diagnosed with BO 3 months after discharge. All 5 patients had patchy shadows,2 patients had uneven inflation combined with thickened tracheal wall; 2 patients had increased pulmonary transparency,and 2 patients had typical mosaic signs. Treatment and prognosis: 5 patients were treated with hormones and immunoglobulins in the acute phase,and 2 patients received plasma exchange. All 5 cases underwent fiber bronchoscopic lavage,1 case had obvious mucosal erosion,and 1 case was a little blocked in the lower trachea. Oral hormones were used in 5 cases after the diagnosis of BO,while nebulized hormones was used and azithromycin and montelukast were taken orally. One of the family members stopped the drug for 1 month. Four patients were followed up for 0.5~3 years. One patient's wheezing had completely improved,two patients had wheezing (successful deoxygenation) while moving,and one patient had some wheezing when being quiet. CT was significantly improved in 1 case. Combining BO in SJS patients affected longterm prognosis,and the clinical manifestations were cough and wheezing,and the improvement in clinical symptoms was earlier than CT

Key words: Stevens-Johnson syndrome, Bronchiolitis obliterans, Wheeze, Children