Stevens-Johnson syndrome/toxic epidermal necrolysis in an orthotopic liver transplant recipient: a case report.
Chun-Sing HuangEmily R StrouphauerChristine O'MahonyNhu T N GalvánRonald CottonJohn GossAbbas RanaPublished in: Journal of surgical case reports (2024)
Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a rare spectrum of acute, mucocutaneous drug reactions characterized by epidermal necrosis of the skin and mucous membranes with progressive multiorgan failure. Cutaneous presentation of SJS/TEN is similar to that of acute graft-versus-host disease, creating a diagnostic dilemma in solid-organ transplant recipients presenting with diffuse, erythematous eruptions, skin sloughing, and systemic sequelae, reflective of both diseases. This case report details a 48-year-old woman post-orthotopic liver transplantation (OLT) who developed a diffuse, painful, morbilliform rash with progressive desquamation, along with corresponding pathological analysis indicative of SJS/TEN. There are few documented reports of SJS/TEN in solid-organ transplant recipients, and this case illustrates successful intervention and resolution of SJS/TEN in an OLT recipient while managing intraabdominal sepsis and an episode of acute rejection. Despite its rarity, prompt diagnosis of SJS/TEN and the implementation of tailored therapeutic strategies are crucial in the care of solid-organ transplant recipients.
Keyphrases
- case report
- liver failure
- wound healing
- respiratory failure
- drug induced
- multiple sclerosis
- healthcare
- aortic dissection
- randomized controlled trial
- primary care
- quality improvement
- acute kidney injury
- soft tissue
- palliative care
- emergency department
- pain management
- high grade
- electronic health record
- mechanical ventilation