Publication: Dual Antiepileptics Induced Stevens-Johnson Syndrome: A Case Report
Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Nepal Medical Association
Abstract
Abstract:
Stevens-Johnson syndrome and Toxic Epidermal Necrolysis are acute mucocutaneous reactions hallmark of which is widespread necrosis and detachment of epidermis. SJS/TEN fall under the single disease spectrum with an incidence rate of 1.0 to 6.0 per 1000000 and 0.4 to 1.2 per 1000000 respectively. Here, we present a case of a 46 years female who developed a generalized erythematous rash over her body, 26 days after being exposed to phenytoin and sodium valproate. Given the strong association between SJS and antiepileptic drugs, and the usual presentation being within the first eight weeks of exposure to susceptible medications; we diagnosed her with SJS. Phenytoin and sodium valproate was withdrawn and she was managed with antihistamines and corticosteroids. She improved significantly within 15 days of our intervention. The mortality rates for SJS and TEN are up to 10% and 30-50% respectively. Early identification of SJS, discontinuation of triggering medicines, and prompt initiation of supportive therapy improve the prognosis.
Description
Prami Nakarmi
Venus Hospital, Mid Baneshwor, Kathmandu, Nepal
Sumit Raut
Kathmandu Medical College, Sinamangal, Kathmandu, Nepal
Siddhartha Manandhar
Zheijang University School of Medicine, 866 Yu Hang Tang Lu, Xihu, Hangzhou, Zhejiang, P.R. China
Abhash Shrestha
Chirayu National Hospital and Medical Institute, Basundhara, Kathmandu, Nepal
Keywords
adverse drug reactions, antiepileptic drugs, case report, stevens-johnson syndrome