Steven Johnson Syndrome Due to Allopurinol Use

Abstract

Introduction Steven Johnson syndrome is a severe cutaneous adverse reaction that develops especially against drugs and has an increasing incidence. The mortality rate in the elderly population is quite high compared to other age groups. Rapid diagnosis, early recognition, and discontinuation of the responsible drug reduce the mortality rate in patients admitted to the emergency department. The most important step in treatment is supportive treatment. Case We present a 70-year-old woman with a history of hypertension, coronary artery disease, known renal failure, and adrenal insufficiency. Steven Johnson syndrome developed. We emphasized that the use of allopurinol due to known renal failure and hyperuricemia increased the mortality rate by causing acute kidney damage, and after its rapid diagnosis and treatment, it positively affected mortality. The patient was admitted to the internal medicine service with a pre-diagnosis of Steven Johnson syndrome in the emergency department and was discharged with recommendations after 26 days of hospitalization. Conclusion Because of the rapid spread and rapid deterioration of the general condition in severe cutaneous reactions such as Steven Johnson, mortality is important to make a rapid diagnosis, to determine the etiology, and to start treatment early.

Keywords

• Steven Johnson Syndrome
• Allopurinol
• Drug adverse effect

Abstract

Giriş Steven Johnson sendromu, özellikle ilaçlara karşı gelişen ve sıklığı giderek artan ciddi bir kutanöz advers reaksiyondur. Yaşlı nüfustaki ölüm oranı diğer yaş gruplarına göre oldukça yüksektir. Sorumlu ilacın hızlı teşhisi, erken tanınması ve kesilmesi, acil servise başvuran hastalarda ölüm oranını düşürmektedir. Tedavide en önemli adım destek tedavisidir. Olgu Sunumu Hipertansiyon, koroner arter hastalığı, bilinen böbrek yetmezliği ve adrenal yetmezlik öyküsü olan 70 yaşında bir kadın hastayı sunuyoruz. Steven Johnson sendromu gelişti. Bilinen böbrek yetmezliği ve hiperürisemiye bağlı allopurinol kullanımının akut böbrek hasarına neden olarak ölüm oranını artırdığını, hızlı tanı ve tedavisinin ardından mortaliteyi olumlu etkilediğini vurguladık. Acil serviste Steven Johnson sendromu ön tanısıyla dahiliye servisine yatırılan hasta, 26 gün yattıktan sonra önerilerle taburcu edildi. Sonuç Steven Johnson gibi ciddi deri reaksiyonlarında genel durumun hızla kötüleşmesi nedeniyle hızlı tanı koymak, etiyolojiyi belirlemek ve tedaviye erken başlamak için önemlidir.

Keywords

• Steven Johnson Sendromu
• Allopürinol
• İlaç yan etkisi

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