Bronchiolitis obliterans with organizing pneumonia and cold agglutinin disease associated with phenytoin hypersensitivity syndrome

P Angle; P Thomas; B Chiu; J Freedman

doi:10.1378/chest.112.6.1697

Bronchiolitis obliterans with organizing pneumonia and cold agglutinin disease associated with phenytoin hypersensitivity syndrome

Chest. 1997 Dec;112(6):1697-9. doi: 10.1378/chest.112.6.1697.

Authors

P Angle¹, P Thomas, B Chiu, J Freedman

Affiliation

¹ Department of Anaesthesia, St. Michael's Hospital, University of Toronto, Ontario, Canada.

PMID: 9404778
DOI: 10.1378/chest.112.6.1697

Abstract

Phenytoin hypersensitivity syndrome (PHS) is a rare delayed hypersensitivity reaction which occurs following exposure to phenytoin sodium. Pulmonary involvement is uncommonly described. Herein is reported the first case of histopathologic bronchiolitis obliterans organizing pneumonia (BOOP) found on open-lung biopsy in a patient with severe PHS. New onset, clinically significant, cold agglutinin disease was also documented. Hemodynamic parameters mimicking sepsis were present in the absence of significant clinical infection. Rapid, dramatic improvement followed high-dose steroid therapy.

Publication types

Case Reports
Review

MeSH terms

Adult
Anemia, Hemolytic, Autoimmune / chemically induced
Anemia, Hemolytic, Autoimmune / diagnosis*
Anemia, Hemolytic, Autoimmune / drug therapy
Anticonvulsants / adverse effects*
Biopsy
Cryptogenic Organizing Pneumonia / chemically induced
Cryptogenic Organizing Pneumonia / diagnosis*
Cryptogenic Organizing Pneumonia / drug therapy
Diagnosis, Differential
Drug Hypersensitivity / complications
Drug Hypersensitivity / diagnosis*
Drug Hypersensitivity / drug therapy
Drug Therapy, Combination
Glucocorticoids / administration & dosage
Humans
Lung / pathology
Male
Phenytoin / adverse effects*
Syndrome

Substances

Anticonvulsants
Glucocorticoids
Phenytoin