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Stevens-Johnson syndrome associated with pancytopenia: a case report
Parikshit Prasai1, Selika Shakya1, Avilasha Singh1
1Kathmandu Medical College and Teaching Hospital.
Annals of Medicine and Surgery (2012)
|July 11, 2024
Summary
Stevens-Johnson syndrome (SJS) with pancytopenia is rare. This case shows pancytopenia resolved with steroids and antibiotics, highlighting potential non-transfusion management for SJS drug reactions.
Area of Science:
- Pharmacology
- Dermatology
- Hematology
Background:
- Stevens-Johnson syndrome (SJS) is a severe hypersensitivity drug reaction.
- Pancytopenia is an exceedingly rare complication of SJS.
Observation:
- A 61-year-old male presented with fever, rash, pancytopenia, and liver injury.
- Skin examination revealed dusky, hyperpigmented macular lesions progressing to ulcerations on the lips, buccal cavity, and toes.
- Causality was confirmed as an adverse drug reaction via Naranjo and ALDEN algorithms.
Findings:
- The patient received intravenous steroids and prophylactic antibiotics.
- Pancytopenia resolved without requiring blood product transfusions.
- The study hypothesizes drug cytotoxicity or immune-mediated bone marrow damage as causes of SJS-associated pancytopenia.
Implications:
- Pancytopenia in SJS may resolve without transfusions, suggesting a need for further research into management strategies.
- Understanding the pathophysiology of SJS-associated pancytopenia is crucial for developing targeted treatments.
- This case underscores the importance of prompt diagnosis and management of severe cutaneous adverse drug reactions.
