Lansoprazole
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Fatal toxic epidermal necrolysis: case report A 57-year-old woman developed toxic epidermal necrolysis (TEN) during treatment with lansoprazole for presumed reflux; her symptoms recurred upon inadvertent rechallenge and she died. The woman, who had a history of chronic renal failure requiring dialysis, started receiving lansoprazole [dosage not stated] during a hospital stay. She developed fever during a dialysis session 2 weeks after discharge, and received tobramycin and vancomycin. A maculopapular rash developed 1 week later; fever with negative blood cultures persisted, and she was hospitalised. On admission, laboratory investigations revealed 20% eosinophils and the following levels: AST 1121 U/L, ALT 1697 U/L and total bilirubin 9.8 mg/dL. A drug reaction was confirmed by liver and skin biopsies, and vancomycin-induced Stevens-Johnson syndrome was diagnosed. The woman received corticosteroids and antihistamines, and her symptoms and laboratory values improved. Lansoprazole was replaced by famotidine during her hospital stay. Lansoprazole was restarted upon discharge; at this time, the woman was also receiving ursodeoxycholic acid, metoprolol and prednisone. She presented to an ICU with recurrent rash and skin peeling 10 days after discharge. She had an intense morbilliform rash on her entire body, including her palms and soles, there was desquamation of over 30% of her body surface area and Nikolsky’s sign was positive. She also had an ulcerating lesion on the roof of her mouth. She was transferred to a burn unit and TEN was confirmed by skin biopsy. She died 1 week later. Ciaccio CE, et al. Fatal toxic epidermal necrolysis after rechallenge with lansoprazole. Annals of Allergy, Asthma and Immunology 100 (Suppl. 1): 71 801100744 abstr. P179, No. 1, Jan 2008 [Abstract] - USA
0114-9954/10/1189-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 16 Feb 2008 No. 1189
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