Stevens-Johnson syndrome presenting with massive oesophageal bleeding

Area of Science:

• Pharmacology
• Dermatology
• Gastroenterology

Background:

• Stevens-Johnson syndrome (SJS) is a severe cutaneous adverse drug reaction.
• Gastrointestinal (GI) complications in SJS are typically mild but can be severe and life-threatening.

Observation:

• A patient with end-stage renal disease developed SJS with severe GI bleeding and hemodynamic instability after antibiotic treatment for sepsis.
• Endoscopic findings revealed esophageal necrotic plaques and mucosal sloughing.

Findings:

• Skin biopsy confirmed SJS.
• The patient required intensive care, blood transfusions, and intravenous dexamethasone for treatment.

Implications:

• Severe GI involvement in SJS is a rare but critical complication.
• Management requires prompt drug withdrawal, intensive care, immunosuppression, and supportive therapies.