Stevens — Johnson syndrome
DOI: 10.32364/2587-6821-2020-4-1-52-57
G.M. Nurtdinova1, E.S. Galimova1, O.I. Kucher2, V.K. Muslimova1
1Bahkir State Medical University, Ufa, Russian Federation
2City Clinical Hospital No. 21, Ufa, Russian Federation
Aim: to assess morbidity pattern and clinical features of Stevens — Johnson syndrome (SJS) in patients of the Department of Allergy of City Clinical Hospital No. 21 (Ufa) in 2008–2018.
Patients and Methods: 10-year retrospective analysis of SJS morbidity in City Clinical Hospital No. 21 was performed. 147 patients (54 men (37%) and 93 women (63%)) were enrolled in the study. Mean age was 46.65±1.4 years. Diagnosis was verified by complex examination including history taking, general examination, laboratory and instrumental tests (complete blood count, blood biochemistry, urinalysis, electrocardiography, chest X-ray).
Results: 133 patients (91%) were diagnosed with SJS and 14 patients (9%) with Lyell’s syndrome. The symptoms were induced by viral infections (cytomegalovirus, herpes simplex virus, human immunodeficiency virus) in 23 patients (15.6%) and various drugs in 94 patients (64%). In 30 patients (20.4%), the cause was unknown. Among 94 patients in whom SJS was induced by drugs, 6 patients taken several medications, therefore, causative drug was not identified. SJS was initiated by antibiotics in 35 patients (37%), non-steroidal anti-inflammatory drugs (NSAIDs) in 14 patients (15%), antivirals in 6 patients (6%), anticonvulsants in 5 patients (5%), antihypertensives in 5 patients (5%), analgesics in 4 patients (4%), vitamins in 4 patients (4%), iodine-containing drugs in 3 patients (3%), and other drugs in 1 patient (1%).
Conclusion: SJS is more common in women than in men. In most cases, triggering factors for SJS and Lyell’s syndrome are medications as well as viral and bacterial causative agents. In most cases, SJS occurs in response to drugs, i.e., NSAIDs and antibiotics.
Keywords: Stevens — Johnson syndrome, toxic epidermal necrolysis, erythema multiforme exudative, drug allergy, antibiotics,
NSAIDs.
For citation: Nurtdinova G.M., Galimova E.S., Kucher O.I., Muslimova V.K. Stevens — Johnson syndrome. Russian Medical Review. 2020;4(1):52–57. DOI: 10.32364/2587-6821-2020-4-1-52-57.
About the authors:
1Guzel M. Nurtdinova — MD, PhD, Associate Professor of the Department of Propaedeutics of Internal Diseases, ORCID iD 0000-0002-1662-821X;
1Elena S. Galimova — MD, PhD, Professor of the Department of Propaedeutics of Internal Diseases, ORCID iD 0000-0002-3788-2284;
2Olga I. Kucher — MD, Head of the Department of Allergy, ORCID iD 0000-0003-3874-6492;
1Viktoriya K. Muslimova — student of the 5th course, ORCID iD 0000-0001-6074-0551.
1Bahkir State Medical University. 3, Lenin str., Ufa, 450008, Russian Federation.
2City Clinical Hospital No. 21. 3, Lesnoi passage, Ufa, 450071, Russian Federation.
Contact information: Elena S. Galimova, e-mail: lenagalimova@mail.ru. Financial Disclosure: no authors have a financial or property interest in any material or method mentioned. There is no conflict of interests. Received 30.01.2020.
1. Pytsky V.I., Adrianova N.V., Artomasova A.B. Allergic diseases. M.: Triad-X; 1999 (in Russ.).
2. Romanova T.S., Myasnikova T.N., Khludova L.G., Latysheva T.V. Fixed erythema drug in the practice of an allergist-immunologist. Rossijskij allergologicheskij zhurnal. 2017;(1):36–40 (in Russ.).
3. Grigoriev D.V. Exudative erythema multiforme, Stevens — Johnson syndrome and Lyell syndrome are a modern interpretation of the problem. Rossijskij medicinskij zhurnal. 2013;(22):1073–1083 (in Russ.).
4. Kartashova M.G., Suhova T.E., Kryazheva S.S. et al. Stevens — Johnson Syndrome. Rossijskij zhurnal kozhnyh i venericheskih boleznej. 2012;(6):13–17 (in Russ.).
5. Allergology and immunology. Ed. Khaitov R.M., Illin N I. M.: GEOTAR-Media; 2009.
6. Fatenkov O.V., Kuzmina T.M., Rubanenko O.A. et al. Correction of an adverse adverse reaction to antibiotic therapy — Stevens — Johnson syndrome. Rossijskij allergologicheskij zhurnal. 2015;(6):68–71 (in Russ.).
7. Romanova T.S., Myasnikova T.N., Khludova L.G., Latysheva T.V. Diagnosis of drug allergy: a modern view of the problem. Rossijskij allergologicheskij zhurnal. 2017;(1):36–40 (in Russ.).
8. Sultanov I. Ya., Ovchinnikova L.V., Gustova A.V. Stevens — Johnson syndrome. Vestnik Rossijskogo universiteta druzhby narodov. Medicina. 2010;(1):137–140 (in Russ.).
9. Haitov R.M. Clinical Allergology. M.: MEDpress-inform; 2006 (in Russ.).
10. Zaslavsky D.V., Gorlanov I.A. Federal Clinical Guidelines for the Management of Patients with Stevens — Johnson Syndrome. Russian Society of Dermatovenerologists and Cosmetologists. 2013 (in Russ.).
11. Kim H.I., Kim S.W., Park G.Y. et al. Causes and treatment outcomes of Stevens — Johnson syndrome and toxic epidermal necrolysis in 82 adult patients. Korean J Intern Med. 2012;27:203–210. DOI: 10.3904/kjim.2012.27.2.203.
12. Hirahara K., Kano Y., Sato Y. et al. Methylprednisolone pulse therapy for Stevens — Johnson syndrome/ toxic epidermal necrolysis: clinical evaluation and analysis of biomarkers. J Am Acad Dermatol. 2013;(69):496–498. DOI:10.1016/j.jaad.2013.04.007.
13. Yamane Y., Matsukura S., Watanabe Y. et al. Retrospective analysis of Stevens — Johnson syndrome and toxic epidermal necrolysis in 87 Japanese patients — Treatment and outcome. AllergolInt. 2016;65:74–81. DOI: 10.1016/j.alit.2015.09.001.
14. Lee H.Y., Dunant A., Sekula P. et al. The role of prior corticosteroid use on the clinical course of Stevens — Johnson syndrome and toxic epidermal necrolysis: a case-control analysis of patients selected from the multinational EuroSCAR and RegiSCAR studies. Br J Dermatol. 2012;(167):555–562. DOI: 10.1111/j.1365-2133.2012.11074.x.
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