Steven Johnsons Syndrome

suzanne4, RN · May 12, 2005

There actually is quite a bit of information on it. It has been around for quite a few years, took care of a patient with it back in the late 1970's.

It can be caused by quite a few different drugs. Once you see it in person, you will never forget it...............

cardiacRN2006, ADN, RN · May 12, 2005

I am in Nursing School (LVN) and this subject came up. We were told by our Instructor to look it up and just know about it. She told us it was caused by Sulpha and said it was bad bad stuff.
Well I did a ton of research on this topic and she was half right. It is bad, bad stuff, but is caused by an allergic reaction to any medication.
It is so rare that Doc's miss it. Get on the net and do some research on this topic, it will break your heart, open your eyes and make you aware of a very severe syndrome that gets missed do to not enough knowledge about the topic.
I almost want to write Medical Book about it.

That's why Bextra was pulled off the marked back in March. I know because my fiancee was on bextra at the time.....

laurakoko · May 12, 2005

Speaking of allergic reactions.......... had a pt that came in with CAD, and had a coronary stent placed to the LAD. About 3 days later, wasn't feeling well, contributed it to the procedure, but then developed a rash. Itchy, red raised bumps, and mild shortness of breath. Called the MD, Rx for Benadryl, didn't have relief, presented to the ER. While there, the symptoms of analphylatic shock increased. Rash, SOB, hypotension. His BP dropped to app 70/40. Suddenly, he had chest pain and L arm numbness. EKG changes, elevated cardiac enzymes. Had an acute MI. It so happened that contrast dye used in the cath lab to place the stent caused the allergic reaction. The reaction caused the hypotension, whiched caused his stent to collapse, resulting in the MI. .....................hmmmm. Watch those reactions, could be fatal. First time in all my years of nursing heard of this... and, I thought I had a bad day...... Unlucky guy........:stone

cardiacRN2006, ADN, RN · May 12, 2005

Speaking of allergic reactions.......... had a pt that came in with CAD, and had a coronary stent placed to the LAD. About 3 days later, wasn't feeling well, contributed it to the procedure, but then developed a rash. Itchy, red raised bumps, and mild shortness of breath. Called the MD, Rx for Benadryl, didn't have relief, presented to the ER. While there, the symptoms of analphylatic shock increased. Rash, SOB, hypotension. His BP dropped to app 70/40. Suddenly, he had chest pain and L arm numbness. EKG changes, elevated cardiac enzymes. Had an acute MI. It so happened that contrast dye used in the cath lab to place the stent caused the allergic reaction. The reaction caused the hypotension, whiched caused his stent to collapse, resulting in the MI. .....................hmmmm. Watch those reactions, could be fatal. First time in all my years of nursing heard of this... and, I thought I had a bad day...... Unlucky guy........:stone

3 days later? That's weird.....Did he die?

UM Review RN, ASN, RN · May 12, 2005

3 days later? That's weird.....Did he die?

Yeah, that is weird. Please update us as to the outcome? :uhoh21:

gwenith, BSN, RN · May 12, 2005

There is a bit of information on this disorder over in the Burns forum.

HONEYBEAR · May 12, 2005

Hi All,

My mom was dx with this disease in Sept of 2003, since then she has had 4 outbreaks-each one placing her in the hospital for longer periods every time........she is now on Valtrex and has not had an outbreak since Sept.2004, she gets monthly lab work.......but the last time she had an outbreak......I was called by the hospital that I needed to be there, it was the longest 24 hour journey back home I have ever taken.......I was not prepared on how she would look......lesions all over her lips, inside her mouth, up her nares, palm of her hands, soles of her feet,........this is a very horrible disease, and when she 1st had these symptoms it took her Doctors 4 days to figure out what it was.......to this day, her doctors do not know what started this disease in my mom, (was not taking any rx meds at the time of her 1st outbreak) :crying2:

Nurseinthemaking · May 12, 2005

Hi All,
My mom was dx with this disease in Sept of 2003, since then she has had 4 outbreaks-each one placing her in the hospital for longer periods every time........she is now on Valtrex and has not had an outbreak since Sept.2004, she gets monthly lab work.......but the last time she had an outbreak......I was called by the hospital that I needed to be there, it was the longest 24 hour journey back home I have ever taken.......I was not prepared on how she would look......lesions all over her lips, inside her mouth, up her nares, palm of her hands, soles of her feet,........this is a very horrible disease, and when she 1st had these symptoms it took her Doctors 4 days to figure out what it was.......to this day, her doctors do not know what started this disease in my mom, (was not taking any rx meds at the time of her 1st outbreak)

Ugh, how terrible. I wonder if it was some kind of chemical that had been sprayed like in the yard or something.

southern rn · May 12, 2005

I have taken care of several people with this disorder. One case was very severe and did not survive, others did recover. They are treated as burn cases due to the open blisters, lesions etc. Almost any med can cause it but I believe lots of the arthritis meds have been identified to be possible culprits. I thought Bextra was pulled from the market due to the link with heart disease being tossed around.

Aneroo, LPN · May 12, 2005

I thought Bextra was pulled from the market due to the link with heart disease being tossed around.

That's what I thought too. Any drug can cause this type of reaction, not just Bextra.

laurakoko · May 12, 2005

I actually thought it was kind of strange that it took 3 days to have the anaphylatic reaction. I talked to the doctor again today, and he said it was normal for that period of time to go by. The doc also said, the reaction began once the contrast was placed, it happened more slowly because he was premedicated with SoluMedrol IV. It was the day after the card cath that he showed s/s, and called the MD office, they Rx Benadryl, and that could have slowed the allergic process. (He took Benadryl PO for 2 days..) Sometimes it also takes time for the body's complement system to recognize and react. The MD related it to like being allergic to honey bees. When a person is stung the first time, he/she might not have anaphylaxis, but the body has enough "poison", to react with swelling/heat as the "allergy." The next time, or maybe few times, a bee stings, the body reacts faster because it recognizes the poision, and can trigger the system better, and result in anaphylaxis. FYI.... I thought it was VERY interesting, and am going to do more research.No, he didn't die, he is doing rather well emotionally, as he talked my head off for about 45 minutes, telling me of his experience.

Medically, he was taken back to the cath lab the following day, and another stent was placed. The echo revealed an anterior wall infarction, but the revascularization was a success, and he should be ok.

He is a very nice man. Told me today, to go along with all of his other tatoos, he is going to tatoo, IODINE allergy across his chest! And being from Louisiana, I told him to remember iodine in shellfish. He said he doesn't like/eat crawfish or crabs anyway.....he prob would have found out about the allergy earlier if he did.............?!?!?!?