The shot was administered to students at several schools in the West Java Province as part of the government’s national immunization program. No other children reported having severe problems, but shortly after receiving the vaccine, the young Syadiah came down with a fever and began complaining of joint pain. A health care provider gave her paracetamol syrup and an “unknown powdered medicine.” But the little girl’s health continued to fail. She started developing rashes over her body and blisters broke out on her skin, lips, tongue and gums. She was admitted to the hospital and diagnosed with SJS.

SJS is a severe adverse reaction to medication that affects about one in a million people each year. There are as many as 200 medications linked to SJS, most commonly antibiotics, anti-inflammatory medicines such as ibuprofen, anti-viral medications such as those for HIV/AIDS, and anti-seizure medicines. As the condition progresses, skin can peel off leaving the body susceptible to infection and possibly even death.

A health official in Depok debunked the notion that medical malpractice is to blame for the girl’s SJS. He is concerned that media coverage of the adverse reaction may scare people from having their children immunized.

“The media’s focus on the wrong reasons behind [Syadiah’s] condition could put the nation in greater danger,” he said.

SOURCE: Stevens Johnson Syndrome › Girl suffers SJS after receiving tetanus shot

SJS and TEN are severe adverse reactions to medication that first express as rashes on the skin. The rashes blister over causing the skin to peel away. Mucus membranes in the eyes, mouth and nose also can be affected and cause serious complications such as dehydration, infection and even death. Serious ocular complications may include permanent vision loss from corneal scaring or vascularization.

The study involved 159 patients over an 8-year period who had been diagnosed with SJS and TEN. Seventy-four percent of the group had acute ocular involvement. Patients with TEN had more frequent but not more severe acute ocular involvement. Sixty-three percent had late ocular complications, with dry eye being the most common complication.

The researchers determined that the severity of the acute ocular disease was found to be the only significant predictor of late complications. The authors suggest that all patients with SJS or TEN undergo initial ophthalmologic screening and follow-up during the acute phase of the disease and that prospective follow-up for up to a year may be necessary.

SOURCE: Stevens Johnson Syndrome › Study focuses on eye complications from SJS/TEN

Intelence is a tablet available only by prescription. It is a type of anti-HIV medicine called a non-nucleoside reverse transcriptase inhibitor (NNRTI), also known as a non-nuke. It is used to control HIV infection in adults and must be used in conjunction with other HIV medications. Intelence is for patients who have previously received treatment for HIV-1 and showed resistance to NNRTIs and protease inhibitors.

The clinical trials revealed that Intelence does carry a slight risk for serious skin reactions such as Stevens Johnson Syndrome (SJS), hypersensitivity reaction and erythema multiforme.

More than 200 medications have been linked to SJS and its more severe form, toxic epidermal necrolysis (TEN), most commonly ibuprofen, antibiotics and anti-seizure medications. SJS and TEN are severe expressions of a simple rash known as erythema multiforme. As the condition worsens, the rashes blister over causing the skin to peel off. Mucus membranes, such as the mouth and eyes, can blister over causing dehydration, infection, blindness and even death.

Patients taking medication, including Intelence, should be aware of the potential life-threatening risk of SJS/TEN

SOURCE: Stevens Johnson Syndrome › HIV treatment linked to slight risk of SJS/TEN

Darunavir, manufactured by Tibotec, belongs to a class of anti-HIV drugs called protease inhibitors (PI). It works to prevent cells infected by HIV from producing new virus, thus reducing the amount of virus in the body. Darunavir must be coadministered with 100-mg ritonavir and with other antiretroviral agents. It was approved by the FDA in June 2006 for HIV-positive adults who were treatment-experienced.

Last October, darunavir was approved for HIV-positive individuals beginning treatment. The medication has proven effective for patients who are not likely to respond to older PIs and for those who are starting antiretroviral therapy for the first time.

SJS and its more severe form, toxic epidermal necrolysis (TEN), are serious adverse reactions to medication. The reaction begins with a rash that blisters over, causing the skin to peel off in sheets. Mucus membranes in the eyes and mouth also can blister over, leading to dehydration, infection, blindness, and even death. More than 200 medications have been linked to SJS and TEN, including NSAIDs such as ibuprofen, antibiotics and anti-seizure medication.

Other warning included in the labeling revisions for darunavir include warnings of potential drug-drug interactions and pregnancy risk. Darunavir should not be taken with dihydroergotamine, ergonovine, ergotamine, methylergonovine, cisapride, pimozide, oral midazolam, triazolam, St. John’s Wort, lovastatin, simvastatin, or rifampin.

Darunavir also should be taken during pregnancy only if the potential benefit justifies the potential risk, according to the report. Mothers on darunavir should not breast feed, and children younger than 3 should not take darunavir.

SOURCE: Stevens Johnson Syndrome › HIV medication carries warning of SJS

Researchers like Wen-Hung are asking why.

SJS is a life-threatening hypersensitivity condition that causes rashes to form over the body. The rashes blister over, causing the skin to peel off in sheets. SJS also can affect the mucus membranes, causing blisters to form in the mouth and eyes. Death can result in about 10 percent of patients with SJS. If it progresses to its most severe form, toxic epidermal necrolysis, (TEN) the death rate soars to 40 to 50 percent. SJS/TEN is linked to more than 200 medications, most commonly ibuprofen, antibiotics and anti-seizure medication.

A group of Chang Gung researchers were aware that the anticonvulsant carbamazepine was linked to many cases of SJS, but through its own study using Taiwanese patients, researchers discovered a possible connection – “a high correlation between hypersensitivity to carbamazepine and a single allele, human leukocyte antigen B1502,” according to the report. As many as 80 percent of Taiwanese carry the allele. The discovery lead to an FDA warning in the U.S. of the increased risk of SJS/TEN for patients of Asian ancestry with the B1502 allele who take carbamazepine.

Since the discovery, researchers began focusing on developing a test to determine whether a patient has the B1502 allele, and lead researcher Wen-Hung turned his attention on a treatment to halt the progression of SJS/TEN.

SOURCE: Stevens Johnson Syndrome › Taiwanese researchers pinpoint genetic marker for SJS

Chung Wen-hung with Chang Gung Memorial Hospital in Taipei, has discovered that granulysin, a naturally occurring substance in the human body, can attack foreign substances or organisms. This discovery may lead to a therapeutic target for further development of an effective treatment for severe immune-mediated disorders that currently have no satisfactory treatment, according to the report. The report is published in last week’s edition of the biomedical research journal Nature Medicine.

SJS accounts for about half of the cases handled by the Taiwan Drug Relief Foundation. It is a rare and sometimes fatal skin disorder that often is caused by medication. SJS and its more severe form, toxic epidermal necrolysis (TEN), are characterized by painful blistering of the skin and skin lesions.

As the condition evolves and skin cells begin to die, skin can literally slough off. Treatment usually focuses on eliminating the underlying cause, if possible, and controlling the symptoms. Recovery can take several weeks to several months.

Chung’s research also appeared in Nature Medicine four years ago when he discovered a link between carbamazepine, an anti-seizure medicine, and patients with SJS. His discovery prompted the Taiwan Department of Health as well as the U.S. Food and Drug Administration to alert healthcare providers of the possible link and recommend genetic screening for the gene before prescribing the medication.

SOURCE: Stevens Johnson Syndrome › Chinese doctor’s discovery may lead to treatment for SJS