Stevens-Johnson Syndrome/Toxic epidermal necrolysis complicated with fulminant type 1 diabetes mellitus: a case report and literature review.
Antiepileptic drugs
Fulminant type 1 diabetes mellitus
Severe cutaneous adverse reactions (SCARs)
Stevens-Johnson syndrome
Toxic epidermal necrolysis
Journal
BMC endocrine disorders
ISSN: 1472-6823
Titre abrégé: BMC Endocr Disord
Pays: England
ID NLM: 101088676
Informations de publication
Date de publication:
02 Sep 2024
02 Sep 2024
Historique:
received:
15
01
2024
accepted:
08
08
2024
medline:
2
9
2024
pubmed:
2
9
2024
entrez:
1
9
2024
Statut:
epublish
Résumé
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening skin lesion triggered by hypersensitive drug reaction. They are characterized by extensive epidermal necrosis and skin exfoliation. Fulminant type 1 diabetes mellitus (FT1DM) is featured by a rapid-onset of hyperglycemia with ketoacidosis due to severely destroyed β-cell function. Fulminant type 1 diabetes mellitus as a sequela of SJS/TEN has rarely been reported. We present a 73-year-old female patient who developed SJS/TEN skin allergic reaction after taking carbamazepine and phenytoin for 35 days. Then, hyperglycemia and diabetic ketoacidosis occurred 20 days after discontinuation of antiepileptic drugs. A very low serum C-peptide level (8.79 pmol/l) and a near-normal glycosylated hemoglobin level met the diagnostic criteria for fulminant T1DM. Intravenous immunoglobulin (IVIG) and insulin were promptly administered, and the patient recovered finally. This rare case indicates that monitoring blood glucose is necessary in SJS/TEN drug reaction, and comprehensive therapy with rehydration, insulin, antibiotics, and IVIG may improve the prognosis.
Sections du résumé
BACKGROUND
BACKGROUND
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening skin lesion triggered by hypersensitive drug reaction. They are characterized by extensive epidermal necrosis and skin exfoliation. Fulminant type 1 diabetes mellitus (FT1DM) is featured by a rapid-onset of hyperglycemia with ketoacidosis due to severely destroyed β-cell function. Fulminant type 1 diabetes mellitus as a sequela of SJS/TEN has rarely been reported.
CASE PRESENTATION
METHODS
We present a 73-year-old female patient who developed SJS/TEN skin allergic reaction after taking carbamazepine and phenytoin for 35 days. Then, hyperglycemia and diabetic ketoacidosis occurred 20 days after discontinuation of antiepileptic drugs. A very low serum C-peptide level (8.79 pmol/l) and a near-normal glycosylated hemoglobin level met the diagnostic criteria for fulminant T1DM. Intravenous immunoglobulin (IVIG) and insulin were promptly administered, and the patient recovered finally.
CONCLUSIONS
CONCLUSIONS
This rare case indicates that monitoring blood glucose is necessary in SJS/TEN drug reaction, and comprehensive therapy with rehydration, insulin, antibiotics, and IVIG may improve the prognosis.
Identifiants
pubmed: 39218880
doi: 10.1186/s12902-024-01683-5
pii: 10.1186/s12902-024-01683-5
doi:
Substances chimiques
Anticonvulsants
0
Carbamazepine
33CM23913M
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
172Informations de copyright
© 2024. The Author(s).
Références
Bastuji-Garin S, Rzany B, Stern RS, et al. Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and Erythema Multiforme. Arch Dermatol. 1993;129:92–6.
doi: 10.1001/archderm.1993.01680220104023
pubmed: 8420497
Chang WC, Abe R, Anderson P, et al. SJS/TEN 2019: from science to translation. J Dermatol Sci. 2020;98:2–12.
doi: 10.1016/j.jdermsci.2020.02.003
pubmed: 32192826
pmcid: 7261636
Mockenhaupt M, Viboud C, Dunant A, et al. Toxic epidermal necrolysis: Assessment of Medication risks with emphasis on recently marketed drugs. The EuroSCAR-Study. J Invest Dermatol. 2008;128:35–44.
doi: 10.1038/sj.jid.5701033
pubmed: 17805350
Imagawa A, Hanafusa T, Miyagawa J, et al. A novel subtype of type 1 diabetes mellitus characterized by a rapid onset and an absence of diabetes-related antibodies. N Engl J Med. 2000;342:301–7.
doi: 10.1056/NEJM200002033420501
pubmed: 10655528
Hanafusa T, Imagawa A. Fulminant type 1 diabetes: a novel clinical entity requiring special attention by all medical practitioners. Nat Clin Pract Endocrinol Metab. 2007;3:36–45.
doi: 10.1038/ncpendmet0351
pubmed: 17179928
Song SO, Yun JS, Ko SH, et al. Prevalence and clinical characteristics of fulminant type 1 diabetes mellitus in Korean adults: a multi-institutional joint research. J Diabetes Investig. 2022;13:47–53.
doi: 10.1111/jdi.13638
pubmed: 34313011
Hosokawa Y, Hanafusa T, Imagawa A. Pathogenesis of fulminant type 1 diabetes: genes, viruses and the immune mechanism, and usefulness of patient-derived induced pluripotent stem cells for future research. J Diabetes Investig. 2019;10:1158–64.
doi: 10.1111/jdi.13091
pubmed: 31161717
pmcid: 6717808
Zhu B, Wu J, Chen G, et al. Fulminant type 1 diabetes mellitus caused by drug reaction with eosinophilia and systemic symptoms (DRESS): a case report and review of the literature. Front Endocrinol. 2019;10:474.
doi: 10.3389/fendo.2019.00474
Ardern-Jones MR, Mockenhaupt M. Making a diagnosis in severe cutaneous drug hypersensitivity reactions. Curr Opin Allergy Clin Immunol. 2019;19:283–93.
doi: 10.1097/ACI.0000000000000546
pubmed: 31247634
Hsu DY, Brieva J, Silverberg NB, et al. Morbidity and mortality of Stevens-Johnson syndrome and toxic epidermal necrolysis in United States adults. J Invest Dermatol. 2016;136:1387–97.
doi: 10.1016/j.jid.2016.03.023
pubmed: 27039263
Guvenir H, Arikoglu T, Vezir E, et al. Clinical phenotypes of severe cutaneous drug hypersensitivity reactions. Curr Pharm Des. 2019;25:3840–54.
doi: 10.2174/1381612825666191107162921
pubmed: 31696807
Arndt KA, Feingold DS. The sign of Pyotr Vasilyewich Nikolsky. N Engl J Med. 1970;282:1154–5.
doi: 10.1056/NEJM197005142822011
pubmed: 5439414
Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, et al. Current perspectives on Stevens-Johnson syndrome and toxic epidermal necrolysis. Clin Rev Allergy Immunol. 2018;54:147–76.
doi: 10.1007/s12016-017-8654-z
pubmed: 29188475
Mittmann N, Knowles SR, Koo M, et al. Incidence of toxic epidermal necrolysis and Stevens-Johnson syndrome in an HIV cohort: an observational, retrospective case series study. Am J Clin Dermatol. 2012;13:49–54.
doi: 10.2165/11593240-000000000-00000
pubmed: 22145749
Mulvey JM, Padowitz A, Lindley-Jones M, et al. Mycoplasma pneumoniae associated with Stevens Johnson syndrome. Anaesth Intensive Care. 2007;35:414–7.
doi: 10.1177/0310057X0703500317
pubmed: 17591139
Maloney NJ, Ravi V, Cheng K, et al. Stevens-Johnson syndrome and toxic epidermal necrolysis-like reactions to checkpoint inhibitors: a systematic review. Int J Dermatol. 2020;59:e183–8.
doi: 10.1111/ijd.14811
pubmed: 32052409
Gu Y, Sebaratnam DF. Contextualising associations of SJS/TEN with COVID-19 and the vaccine. Burns. 2023;49:1776–7.
doi: 10.1016/j.burns.2023.08.003
pubmed: 37833150
Le Cleach L, Delaire S, Boumsell L, et al. Blister fluid T lymphocytes during toxic epidermal necrolysis are functional cytotoxic cells which express human natural killer (NK) inhibitory receptors. Clin Exp Immunol. 2000;119:225–30.
doi: 10.1046/j.1365-2249.2000.01119.x
pubmed: 10606987
pmcid: 1905549
Imagawa A, Hanafusa T, Awata T, et al. Report of the Committee of the Japan Diabetes Society on the research of fulminant and acute-onset type 1 diabetes mellitus: new diagnostic criteria of fulminant type 1 diabetes mellitus. J Diabetes Investig. 2012;3:536–9.
doi: 10.1111/jdi.12024
pubmed: 24843620
pmcid: 4015434
Onuma H, Tohyama M, Imagawa A, et al. High frequency of HLA B62 in fulminant type 1 diabetes with the drug-induced hypersensitivity syndrome. J Clin Endocrinol Metab. 2012;97:E2277–81.
doi: 10.1210/jc.2012-2054
pubmed: 23071161
Kano Y, Tohyama M, Aihara M, et al. Sequelae in 145 patients with drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms: Survey conducted by the Asian Research Committee on severe cutaneous adverse reactions (ASCAR). J Dermatol. 2015;4:276–82.
doi: 10.1111/1346-8138.12770
Elmore S, Apoptosis. A review of programmed cell death. Toxicol Pathol. 2007;35:495–516.
doi: 10.1080/01926230701320337
pubmed: 17562483
pmcid: 2117903
Chiou CC, Chung WH, Hung SI, et al. Fulminant type 1 diabetes mellitus caused by drug hypersensitivity syndrome with human herpesvirus 6 infection. J Am Acad Dermatol. 2006;54(2 Suppl):S14–7.
doi: 10.1016/j.jaad.2005.03.057
pubmed: 16427984
Schneider JA, Cohen PR. Stevens-Johnson syndrome and toxic epidermal necrolysis: a concise review with a Comprehensive Summary of therapeutic interventions emphasizing supportive measures. Adv Ther. 2017;34:1235–44.
doi: 10.1007/s12325-017-0530-y
pubmed: 28439852
pmcid: 5487863
de Prost N, Ingen-Housz-Oro S, Duong T, et al. Bacteremia in Stevens-Johnson syndrome and toxic epidermal necrolysis: Epidemiology, risk factors, and predictive value of skin cultures. Med (Baltim). 2010;89:28–36.
doi: 10.1097/MD.0b013e3181ca4290
Zimmermann S, Sekula P, Venhoff M, et al. Systemic immunomodulating therapies for Stevens-Johnson syndrome and toxic epidermal necrolysis: a systematic review and Meta-analysis. JAMA Dermatol. 2017;153:514–22.
doi: 10.1001/jamadermatol.2016.5668
pubmed: 28329382
pmcid: 5817620