Document Detail


Mucous membrane pemphigoid with fatal bronchial involvement in a seventeen-year-old girl.
MedLine Citation:
PMID:  16670490     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This study was designed to report a case of biopsy-proven mucous membrane pemphigoid with severe bronchial involvement in a young woman. METHODS: Case report of a 17-year-old girl who presented with worsening dyspnea, skin rash, and bilateral ocular injection, symblepharon, and fornix foreshortening. Conjunctival, skin, and bronchial biopsies were performed along with imaging and serological tests in an effort to establish a diagnosis for this unusual constellation of findings. The surprising occurrence of a cerebrovascular accident during her hospitalization also prompted a search for a concurrent coagulation disorder. RESULTS: Immunofluorescence studies of conjunctival, skin, and bronchial tissue specimens revealed deposition of multiple antibody classes at the basement membrane zone. The patient also possessed circulating basement membrane zone antibodies in her serum and a significant titer of antiphospholipid antibodies. She underwent dilation and stent placement for subglottic tracheal and left bronchial stenosis and was treated with immunosuppressive agents. After a favorable initial response, the patient experienced progressive bronchial stenosis and respiratory compromise, culminating in her death from bronchospasm and cardiopulmonary arrest. CONCLUSION: To our knowledge, this is the first report of mucous membrane pemphigoid involving the lower airways that was confirmed by immunofluorescence analysis. It highlights the potentially lethal, systemic nature of mucous membrane pemphigoid and underscores the need to question patients about symptoms of respiratory dysfunction.
Authors:
David M Gamm; Alexis Harris; Reza J Mehran; Mark Wood; C Stephen Foster; V Vinod Mootha
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cornea     Volume:  25     ISSN:  0277-3740     ISO Abbreviation:  Cornea     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-03     Completed Date:  2006-06-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8216186     Medline TA:  Cornea     Country:  United States    
Other Details:
Languages:  eng     Pagination:  474-8     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antibodies, Antiphospholipid / analysis
Bronchial Diseases / complications*,  diagnosis
Conjunctival Diseases / complications*,  diagnosis
Fatal Outcome
Female
Fibrosis / complications,  diagnosis
Humans
Mediastinal Diseases / complications,  diagnosis
Pemphigoid, Benign Mucous Membrane / complications*,  diagnosis
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Antibodies, Antiphospholipid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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