Stevens Johnson Syndrome in a patient with systemic lupus erythematosus on tuberculostatic treatment

  • Alius Cahyadi Department of Internal Medicine, Faculty of Medicine, Atma Jaya University - Atma Jaya Hospital, Jakarta, Indonesia
  • Karina Anindita Department of Internal Medicine, Faculty of Medicine, Atma Jaya University - Atma Jaya Hospital, Jakarta, Indonesia
  • Maria R. Iryaningrum Department of Internal Medicine, Faculty of Medicine, Atma Jaya University - Atma Jaya Hospital, Jakarta, Indonesia
Keywords: Stevens Johnson Syndrome, systemic lupus erythematosus
Abstract viewed: 3877 times
PDF downloaded: 916 times

Abstract

A 22-year-old woman was admitted to the hospital because of 5-days history of redness and itch on her face. Additional complains were swelling on her feet, sore throat, and cough. Patient was on treatment for systemic lupus erythematosus and pulmonary tuberculosis (since 12 days). On physical examination, patient was alert, stable hemodynamic, anasarca edema, multiple purpuric macules lesion spread on her body, conjunctivitis of both eyes, multiple oral ulcers, erythema on genital mucosa. Laboratory results were anemia, leucopenia, hypoalbuminemia, proteinuria. We suspected this patient as Stevens Johnson syndrome due to tuberculostatic drugs. During treatment, we stopped the tuberculostatic drugs, and gave her parenteral methylprednisolone, with other supportive treatments. The patient was discharge after improvement of clinical condition and capable of self mobilization. (Med J Indones. 2012;21:235-9)

References

  1. Hahn BH. Systemic lupus erythemathosus. In: Longo DL, Kasper DL, Jameson JL, Fauci AS, Hauser SL, Loscalzo J, editors. Harrison's principal of internal medicine. 18th ed. USA: The McGraw-Hill Companies, Inc.; 2012. p. 2724-35.

  2. Tutuncu ZN, Kalunian KC. The definition and classification of systemic lupus erythematosus. In: Wallace DJ, Hahn BH, editors. Dubois' lupus erythematosus. 7th ed. USA: Lippincott Williams & Wilkins; 2007. p. 16-20.

  3. Hahn BH. Systemic lupus erythematosus. In: Fauci AS, Langford CA, editors. Harrison's rheumatology. 2nd ed. USA: The McGraw-Hill Companies, Inc.; 2010. p. 66-81.

  4. Pisetsky DS. Systemic lupus erythematosus: B. Epidemiology, pathology, and pathogenesis. In: Klippel JH, Stone JH, Crofford LJ, White PH, editors. Primer on the rheumatic disease. 13th ed. USA: Springer Science+Bussiness Media, LLC; 2008. p. 319-26.

  5. Buyon JP. Systemic lupus erythematosus: A. Clinical and laboratory features. In: Klippel JH, Stone JH, Crofford LJ, White PH, editors. Primer on the rheumatic disease. 13th ed. USA: Springer Science+Bussiness Media, LLC; 2008. p. 303-18. https://doi.org/10.1007/978-0-387-68566-3_15

  6. Ruiz-Irastorza G, Olivares N, Ruiz-Arruza I, Martinez-Berriotxoa A, Egurbide MV, Aguirre C. Predictors of major infections in systemic lupus erythematosus. Arthritis Res Ther. 2009;11(4):1-8. https://doi.org/10.1186/ar2764

  7. Schulz SW, Derk CT. The gastrointestinal manifestations of systemic lupus erythematosus: a survey of the literature. The Open Autoimmunity Journal. 2009;1:10-26. https://doi.org/10.2174/1876894600901010010

  8. Fritsch PO, Maldonado RR. Erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis. In: Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, editors. Fitzpatrick's dermatology in general medicine. 6th ed. USA: The McGraw-Hill Companies, Inc.; 2003.

  9. Djuanda A, Hamzah M. Sindrom Stevens-Johnson. In: Djuanda A, Hamzah M, Aisah S, editors. Ilmu penyakit kulit dan kelamin. 4th ed. Jakarta: Balai Penerbit FKUI; 2005. p.163-5. Indonesian.

  10. Bertsias G, Loannidis JPA, Boletis J, Bombardieri S, Cervera R, Dostal C, et al. EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies including Therapeutics. Ann Rheum Dis. 2008;67:195-205. https://doi.org/10.1136/ard.2007.070367

  11. Manzi S, Kao AH. Systemic lupus erythematosus: C. Treatment and assessment. In: Klippel JH, Stone JH, Crofford LJ, White PH, editors. Primer on the rheumatic disease. 13th ed. USA: Springer Science+Bussiness Media, LLC; 2008. p. 327-38.

  12. Tyagi S, Kumar S, Kumar A, Singla M, Singh A. Stevens-Johnson syndrome- a life threatening skin disorder: a review. J Chem Pharm Res. 2010;2(2):618-26.

Published
2012-11-01
How to Cite
1.
Cahyadi A, Anindita K, Iryaningrum MR. Stevens Johnson Syndrome in a patient with systemic lupus erythematosus on tuberculostatic treatment. Med J Indones [Internet]. 2012Nov.1 [cited 2021Dec.6];21(4):235-9. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/507
Section
Case Report/Series