Sjogren's syndrome and drug reaction to practalol

A case is reported of a patient who developed exfoliative dermatitis while being treated with practalol for angina pectoris. The patient also had trigeminal neuropathy, renal impairment and keratoconjunctivitis sicca. The antinuclear factor was diffusely positive but other antibodies were negative. At post mortem the patient was found to have acute pancreatitis, and peritonitis. It is postulated that the patient has antecedent Sjogren's syndrome and on introduction of practalol therapy developed a drug reaction with a generalised exfoliative dermatitis and exacerbation of keratoconjunctivitis sicca leading to bilateral corneal ulceration. The association of similar conditions in patients receiving practalol therapy is reviewed.