A fatal case of cutaneous adverse drug-induced toxic epidermal necrolysis associated with severe rhabdomyolysis

Noordally, S. Oaleed; Sohawon, Schoeb; Vanderhulst, Julien; Duttmann, Ruth; Corazza, Francis; Devriendt, Jacques

doi:10.5144/0256-4947.2012.309

Cited by 7 publications

(5 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…6 Drug notoriety was determined using different reviews that assessed medication risk of inducing SJS or TEN and case reports. 2,3,[7][8][9][10][11][12][13] Amoxicillin (aminopenicillin) and diclofenac gel (acetic acid NSAID) are both considered to have a definite but lower risk of causing epidermal necrolysis. 7 Brinzolamidetimolol drops, ibuprofen and naproxen (propionic acid NSAIDs), and pregabalin (gabapentinoid) have been loosely associated to severe cutaneous adverse reactions in case reports.…”

Section: Discussionmentioning

confidence: 99%

“…7 Brinzolamidetimolol drops, ibuprofen and naproxen (propionic acid NSAIDs), and pregabalin (gabapentinoid) have been loosely associated to severe cutaneous adverse reactions in case reports. 2,3,[7][8][9][10][11][12][13] All of these medications were stopped before resolution of the TEN. The patient had received ibuprofen previously without any reaction demonstrating a negative prechallenge.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Identification of Possible Causative Agents in a Polymedicated Patient Presenting With Toxic Epidermal Necrolysis

Khazaka

Laverdière

Bouchard

et al. 2020

Journal of Pharmacy Practice

View full text Add to dashboard Cite

Purpose: To present the pharmacological evaluation process in a case of a polymedicated patient presenting with toxic epidermal necrolysis (TEN). Summary: A 75-year-old Caucasian polymedicated woman had been treated for hip pain with nonsteroidal anti-inflammatory drugs and pregabalin in the months preceding the apparition of an expanding papulo-erythematous rash. She had also started using new medicated eye drops for glaucoma. She presented to the emergency department of a regional hospital where all of her medications were stopped. The patient was transferred and admitted to a tertiary-care teaching hospital’s specialized burn unit for significant cutaneous detachment. It was estimated that 70% to 80% of the body surface area was affected. Skin biopsy showed keratinocyte necrosis with a partial detachment of the epidermis leading to a diagnosis of TEN. The reaction ceased to progress 2 days after the discontinuation of her medications. A complete reepithelialization was objectified after 10 days. A series of steps were followed by the hospital pharmacist to determine which drugs were the most probable culprits. A complete pharmacological history was obtained and a timeline for medication use in the 3 months preceding rash apparition was established. A review of the literature was done to determine the drugs’ relationships to Steven-Johnson syndrome or TEN. Using the algorithm of drug causality for epidermal necrolysis (ALDEN) score, it was determined that naproxen, pregabalin, and brinzolamide–timolol drops were all possible culprits. Conclusion: A systematic method for pharmacological evaluation of a polymedicated patient with TEN is presented. Naproxen, pregabalin, and brinzolamide–timolol drops were all retained as possible culprits.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Identification of Possible Causative Agents in a Polymedicated Patient Presenting With Toxic Epidermal Necrolysis

Khazaka

Laverdière

Bouchard

et al. 2020

Journal of Pharmacy Practice

View full text Add to dashboard Cite

show abstract

“…Rare cases of TEN with rhabdomyolysis have been reported in association with carbamazepine and statins but not with allopurinol to the best of our knowledge. 10,11 It is postulated that TENmediated cellular and immune responses impair mitochondrial function, thereby altering sodium-calcium homeostasis, leading to skeletal muscle breakdown. 12 We speculate that this maybe a contributing factor to the rhabdomyolysis in addition to the period of immobility before admission to the ICU.…”

Section: Discussionmentioning

confidence: 99%

Rapidly Progressing Severe Cutaneous Adverse Reaction With Acute Kidney Injury After Drug Exposure

Rodgers

Kumar²

2016

American Journal of Therapeutics

View full text Add to dashboard Cite

Toxic epidermal necrolysis syndrome (TEN) is a rare severe cutaneous adverse drug reaction that involves skin and mucous membranes. We describe a case of TEN presenting with stage III acute kidney injury, rhabdomyolysis, and acute respiratory failure likely triggered by allopurinol for recently diagnosed gout. Prompt diagnosis, multidisciplinary management, including aggressive resuscitation, cardiorespiratory support, intravenous immunoglobulin therapy, and daily wound care resulted in a positive outcome despite a predicted mortality greater than 60%. Although allopurinol is a known triggering agent, TEN presenting with rhabdomyolysis and acute kidney injury is rare.

show abstract

“…There have been 6 reports of statin-induced exfoliative dermatitis in the literature, including TEN, but none of the studies tested for HLA-related genes. [ 9 , 10 , 11 , 12 , 13 , 14 ] In addition, it is mentioned on the atorvastatin drug label that it may cause TEN in extremely rare cases. [ 15 ]…”

Section: Discussionmentioning

confidence: 99%

Toxic epidermal necrolysis in a patient on atorvastatin therapy expressing human leukocyte antigen alleles

Jiang

et al. 2021

Medicine

View full text Add to dashboard Cite

Rationale: Toxic epidermal necrolysis (TEN) is a rare, severe mucosal response of the skin associated with a high mortality rate. TEN is most commonly caused by drugs, and is characterized by extensive skin epidermal exfoliation. Patient concerns: A 68-year-old woman presented with a rash that had persisted for four days. The patient who had undergone a mitral valve replacement 1 month prior and was taking atorvastatin at the time of admission. Diagnoses: The patient exhibited more than 30% exfoliation surfaces and the severe drug eruption was considered to be TEN. According to human leukocyte antigen (HLA) allele detection and ALDEN score, HLA alleles which found in this case report may be an cause of TEN induced by atorvastatin. Interventions: All drugs used prior to admission were discontinued and the patient was given antiallergic drugs. Outcomes: After 3 weeks following Antiallergic treatment, the rash on patient's calf had subsided, the edema was relieved, and the patient was no longer experiencing pain. After 60 days following discharge, the patient's skin has regrown. Lessons: This is the first report describing the induction of TEN by atorvastatin in a HLA alleles carrier. For HLA alleles carrier, atorvastatin may need to be used with caution to avoid TEN. Future systematic research is also required to confirm this finding and avoid similar serious skin adverse reactions.

show abstract

A fatal case of cutaneous adverse drug-induced toxic epidermal necrolysis associated with severe rhabdomyolysis

Cited by 7 publications

References 7 publications

Identification of Possible Causative Agents in a Polymedicated Patient Presenting With Toxic Epidermal Necrolysis

Identification of Possible Causative Agents in a Polymedicated Patient Presenting With Toxic Epidermal Necrolysis

Rapidly Progressing Severe Cutaneous Adverse Reaction With Acute Kidney Injury After Drug Exposure

Toxic epidermal necrolysis in a patient on atorvastatin therapy expressing human leukocyte antigen alleles

Contact Info

Product

Resources

About