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Stevens-Johnson syndrome associated with furosemide: a case report
Amanda A Wright1, Kimi S Vesta, Jennifer E Stark
1University of Oklahoma College of Pharmacy, Oklahoma City, OK, USA.
Journal of Pharmacy Practice
|April 22, 2011
Summary
A probable link between Stevens-Johnson Syndrome (SJS) and furosemide is reported. This rare adverse drug reaction may occur months after starting furosemide, with potential cross-sensitivity to lincomycin and silver sulfadiazine cream.
Area of Science:
- Pharmacovigilance
- Dermatology
- Internal Medicine
Background:
- Stevens-Johnson Syndrome (SJS) is a severe mucocutaneous adverse drug reaction (ADR).
- Identifying the causative agent in prolonged SJS cases can be challenging.
- Furosemide, a loop diuretic, is rarely associated with SJS.
Observation:
- A 28-year-old male presented with SJS of unclear etiology.
- Symptoms initially improved upon hospitalization but worsened with furosemide rechallenge.
- Rash reappearance and worsening correlated with furosemide and silver sulfadiazine cream use.
Findings:
- Naranjo ADR Probability Scale indicated a probable association between SJS and furosemide.
- Evidence suggests initial SJS development due to furosemide, with subsequent worsening linked to lincomycin.
- Suspected cross-sensitivity between furosemide, lincomycin, and silver sulfadiazine cream.
Implications:
- Clinicians should consider furosemide as a potential cause of SJS, even with long-term use.
- Awareness of potential cross-sensitivity among related drug classes is crucial for patient safety.
- Prompt identification and withdrawal of the offending agent are key to managing SJS.
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