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Drugs as etiologic factors in the Stevens-Johnson syndrome

1968; Elsevier BV; Volume: 44; Issue: 3 Linguagem: Inglês

10.1016/0002-9343(68)90110-1

1555-7162

Joseph R. Bianchine, Placido V. J. Macaraeg, Louis Lasagna, Daniel L. Azarnoff, S.fred Brunk, Eigill F. Hvidberg, John Andrew Owen,

Asthma and respiratory diseases

A retrospective analysis of drugs as possible etiologic factors in 138 cases of Stevens-Johnson syndrome made at five university medical centers from 1952 through 1965 is presented. Three different patterns of clinical presentation are noted. In the simplest form, the complete syndrome occurs in a setting of good general health with no apparent exogenous drug factors present. The second type is heralded by similar signs and symptoms suggestive of an upper respiratory tract or urinary tract infection for which one or more drugs are administered before the appearance of the complete Stevens-Johnson syndrome. In the third type of presentation, the Stevens-Johnson syndrome follows drug treatment of symptoms unlike the prodromas of the Stevens-Johnson syndrome. The variety of drugs involved, the possible role of these drugs in the subsequent development of the Stevens-Johnson syndrome and the difficulty in relating “cause and effect” are discussed. Penicillins were the drugs most frequently associated with the Stevens-Johnson syndrome. Our data provide little basis for suspecting long-acting sulfonamides as an important etiologic factor in the Stevens-Johnson syndrome.