Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 5-year-old girl with Stevens-Johnson syndrome developed progressive dysphagia secondary to esophageal stenosis. The authors resolved this by treating the patient with balloon dilatation. She has remained symptom-free for 10 months post-treatment.
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PMID:Esophageal stenosis following Stevens-Johnson syndrome. Treatment with balloon dilation. 236 42

We report a 7-year-old male with ampicillin-induced Stevens-Johnson syndrome with subsequent extensive skin, conjunctival, oropharyngeal, and laryngeal involvement. Over the next 5 months, he developed complete blindness and dysphagia. A barium swallow revealed absence of both right and left pyriform sinus, and a stricture involving the entire esophagus. Retrograde dilatations, complicated by malignant hyperthermia, have subsequently allowed for the difficult progression from an eight to a 40 French bougie. Eighteen months since the diagnosis of esophageal stricture, he has a normal appearing esophagus and is swallowing without difficulty.
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PMID:Esophageal stricture secondary to Stevens-Johnson syndrome. 343 Mar 22

Three cases of Stevens-Johnson syndrome with intestinal involvement are described. Two patients had esophageal involvement, the severity of which paralleled skin lesions and, in 1 case, probably contributed to death. Dysphagia and bleeding were manifestations. The third patient was unique and had gastric, small and large bowel involvement with sparing of other mucosae. Cramps, severe exudative diarrhea, and bleeding were major clinical features. Unusual histologic features included sloughing of cells into the gland lumina of intestinal mucosa.
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PMID:Gastrointestinal involvement complicating Stevens-Johnson syndrome. 372 Nov 30

Esophageal stricture and web are described in a 14-year-old girl who presented with a history of progressive dysphagia subsequent to an episode of Stevens-Johnson syndrome at the age of 4.
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PMID:Esophageal stricture and web secondary to Stevens-Johnson syndrome. 662 91

Dysphagia describes the disability or problems in swallowing a wet or dry bolus properly and is normally associated with an impaired transport of the bolus. Dysphagia can be accompanied by a pain sensation in the chest mostly caused by impaction of the food bolus in the esophagus. Odynophagia describes only the status of painful swallowing without an impairment of the swallow and transport function. Drug-induced dysphagia can be caused in two different ways. First as a normal drug side effect of the pharmacological action of the drug or as a complication of the therapeutic action of the drug. The normal drug side effect is most likely in drugs that affect smooth or striated muscle function or the sensitivity of the mucosa. The drug effect on smooth muscle function that causes dysphagia can be inhibitory or excitatory. Dysphagia is a common clinical symptom in patients with reduced perception of the pharyngeal mucosa which leads to an subjective impairment of swallowing. Dysphagia caused by a complication of the therapeutic action of a drug includes viral or fungal esophagitis in patients treated with immunosuppressive drugs or cancer therapeutic agents, or antibiotics and immunological reactions to certain drugs such as erythema exsudativa multiforme or Stevens-Johnson syndrome. Second, drug-induced dysphagia can be due to medication-induced esophageal injury (MIEI). In most cases this mucosal injury appears to be the direct result of prolonged contact of a potentially caustic drug with the esophageal mucosa. This form of medication-induced esophagitis is most likely to be found in elderly patients and patients with esophageal motility disorders.(ABSTRACT TRUNCATED AT 250 WORDS)
Dysphagia 1993
PMID:Drug-induced dysphagia. 846 24

The authors describe the endoscopic aspect of esophageal lesions in five children with Stevens-Johnson syndrome. Lesions involve the entire esophagus, with blistering of the epithelium leading to large ulcerations of the mucosae. Esophageal involvement is probably underestimated in Stevens-Johnson syndrome and may worsen dysphagia caused by oral lesions, leading to malnutrition. Enteral nutrition can be helpful to provide feeding, limit weight loss, and support skin healing. No strictures were diagnosed during the follow-up period of these patients.
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PMID:Esophageal involvement in Stevens-Johnson syndrome. 1143 52

Clinical decisions often have to be made in the absence of evidence. In some cases, it is appropriate to use evidence from similar but more common conditions for which studies have resulted in evidence-based practice. This report describes a case of oesophageal stricture following Stevens-Johnson syndrome illustrating this concept, although it is likely that there are many other conditions in which the same principle will stand the clinician in good stead. Dilatation led to long-standing relief of dysphagia in our case.
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PMID:Oesophageal stricturing secondary to adult Stevens-Johnson syndrome: similarities in presentation and management to corrosive injury. 1270 Oct 21

Toxic epidermal necrolysis (TEN) is a rare and potentially fatal skin disorder, precipitated by severe allergic drug reaction, and is one of a spectrum of conditions, which includes Stevens-Johnson syndrome (SJS). Mucosal involvement is common, resulting in extreme pain on swallowing and poor oral intake. The aim of this study was to describe swallow function in TEN and SJS and define the role of Speech Pathology in management. The Burns Unit database was reviewed for patients that presented over a five-year period with TEN and SJS. Diagnosis of TEN and SJS was confirmed by skin biopsy. Information specific to swallow function, treatment approaches, and adequacy of oral intake was collected. Fourteen patients' medical records were studied: eight TEN, two TEN/SJS spectrum, and four SJS. The majority had mucosal involvement causing odynophagia, poor oral intake, an ability to tolerate fluids more easily than solids, and increased aspiration risk. These symptoms were confirmed by Speech Pathology swallowing assessment. Severe mucosal involvement resulting in odynophagia, dysphagia, and poor oral intake is common in TEN and SJS. The speech pathologist is able to assess swallow function and provide recommendations to promote safe oral intake, minimize odynophagia, and facilitate nutritional input critical to optimizing recovery.
Dysphagia 2007 Jul
PMID:Management of dysphagia in toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS). 1728 25

Erythema multiforme (EM), Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (TEN) have been reported as possible adverse effects of some classes of first-line antiretroviral drugs (ART) for HIV treatment. Herein we report an unusual presentation of TEN lesions associated with ART in an HIV-infected patient. The patient presented disseminated cutaneous eruption and oral lesions from the lips to the oropharynx region, causing odynophagia and dysphagia. In the tongue, circular, atypical erythematous lesions appeared, increasing in diameter over seven days and coalescing since then to complete remission. TEN treatment included efavirenz interruption, use of methylprednisolone, prophylactic antibiotic, and daily laser therapy with low-intensity red light. The circular oral lesions have not been described yet. Reporting our findings and clinical management may help diagnosing other similar cases and guide the clinical conduct. Analgesia and acceleration of oral ulcer repair with red laser therapy are recommended.
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PMID:Unusual oral findings of the toxic epidermal necrolysis in an HIV-infected patient: a case report. 3156 53