Stevens–Johnson syndrome/toxic epidermal necrolysis and erythema multiforme drug-related hospitalisations in a national administrative database
نویسندگان
چکیده
Background Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and erythema multiforme (EM) are immunologically-mediated dermatological disorders commonly triggered by drug exposure and/or other external agents. We aimed to characterise SJS/TEN- and EM-drug-related hospitalisations in a nationwide administrative database, focusing on demographic and clinical characteristics, and in the most frequently implicated drug classes. Methods We analysed all drug-related hospitalisations with associated diagnosis of SJS/TEN or EM in Portuguese hospitals between 2009 and 2014. We compared gender, age, comorbidities, length of stay, and in-hospital mortality and estimated the number of episodes per million packages sold of drug classes. Predictors of in-hospital mortality were investigated in both conditions by logistic regression. Results There were 132 SJS/TEN-related and 122 EM-related hospitalisations. Incidence and in-hospital mortality of SJS/TEN episodes (24.2%) were consistent with previous studies. HIV co-infection was more common among SJS/TEN hospitalisations (9 vs. 2% with EM; P = 0.009). Liver disease, advanced age, and a TEN diagnosis, were significantly associated with higher risk of mortality in patients with SJS/TEN. The highest numbers of SJS/TEN and EM episodes per million drug packages sold were observed for antivirals (8.7 and 1.5, respectively), antineoplastic/immunosuppressive drugs (5.6 and 3.9, respectively) and hypouricaemic drugs (5.0 and 2.4, respectively). Conclusions SJS/TEN in-hospital mortality is high, and its risk factors include advanced age, liver disease, and TEN diagnosis. The drug classes most frequently associated with these conditions include antivirals, hypouricaemic drugs and antineoplastic/immunosuppressive drugs. Administrative databases seem useful in the study of SJS/TEN drug-related hospitalisations, yielding results consistent with previous studies and on a nationwide basis.
منابع مشابه
Correlations between clinical patterns and causes of erythema multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis: results of an international prospective study.
BACKGROUND It was proposed that Stevens-Johnson syndrome and toxic epidermal necrolysis differed from erythema multiforme majus by the pattern and localization of skin lesions. OBJECTIVE To evaluate the validity of this clinical separation. DESIGN Case-control study. SETTINGS Active survey from 1989 to 1995 of 1800 hospital departments in Europe. PATIENTS A total of 552 patients and 172...
متن کاملAn Epidemiological Study of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis during 2010-2015 at Shahid Faghihi Hospital, Shiraz, Iran
The Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are two ends of the spectrum of severe immunobullous state characterized by keratinocyte apoptosis. The present study aimed to draw attention to various epidemiological features of SJS and TEN diseases such as causative drugs, underlying diseases, duration of hospitalization, and types of treatment. The records of all patie...
متن کاملCauses and treatments of Stevens - Johnson syndrome and toxic epidermal necrolysis in Iranian patients
Aims: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious severe cutaneous adverse reactions with high mortality and morbidity induced by medications. In this cross sectional study, we investigated, suspected drugs, and potential treatments of SJS/TEN. Methods: A cross- sectional descriptive study was conducted on 60 patients admitted with a diagnosis of Stevens-Jo...
متن کاملReactivation of Cytomegalovirus in a Patient with Stevens-Johnson Syndrome-Toxic Epidermal Necrolysis
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe adverse cutaneous reactions to drugs. We describe the case of a 19 year old patient with SJS/TEN overlap syndrome, who developed severe interstitial pneumonia after she had received antiepileptic drugs. A cytomegalovirus infection was diagnosed by Real Time Polymerase Chain Reaction (RT-PCR) detection on Bronchoalveo...
متن کامل396 Risk Factors Associated to Mortality in Mmexican Children with Stevens-Johnson Sndrome/Toxic Epidermal Necrolysis
day. Conclusions: Symptomes and appearence of the disease suggested several diseases but the laboratory tests were normal, making the diagnosis more difficult, the supposed diagnosis did not fit properly for the patient age. Careful observation of patients and the disease, exfoliative cytology and a biopsy, microbiological investigations allow the diagnosis, ruling out erythema multiforme and d...
متن کامل