SÍNDROME DE STEVENS-JOHNSON SECUNDARIO A ALOPURINOL: PRESENTACIÓN DE UN CASO. HOSPITAL SANTO TOMÁS. SEPTIEMBRE 2005.

José Isaac Latorraca; Joel Moreno Ríos; Yolanda Rivera

Enviado octubre 30, 2024

Publicado 2026-04-06

Artículos de Investigación

Vol. 19 Núm. 1 (2006): Revista Médico Cientifica

SÍNDROME DE STEVENS-JOHNSON SECUNDARIO A ALOPURINOL: PRESENTACIÓN DE UN CASO. HOSPITAL SANTO TOMÁS. SEPTIEMBRE 2005.

José Isaac Latorraca⁺⁻
Joel Moreno Ríos⁺⁻
Yolanda Rivera⁺⁻

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DOI: ND

Publicado: 2026-04-06

Derechos de autor 2024 Revista médico científica

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.

Resumen

El Síndrome de Stevens-Johnson es una entidad poco frecuente, con una incidencía mundial promedio de 1,2 - 6 casos por 1 000 000 habitantes. Causado debido a una reacción idiosincrática a la ingesta de determinados alimentos, infecciones o medicamentos. Se presenta el caso de un paciente masculino de 46 años quien acude por cuadro c1inico caracterizado por la aparición de lesiones eritematopapulosas, vesiculares y pustulosas en labios, cavidad oral, extremidades y glande; seguido de fiebre, edema periorbitario, conjuntivitis purulenta y hemorragia conjuntival; el cuadro se desarrolla 24 horas después de la ingesta de alopurinol, prescrito por cuadro gotoso de primer dedo del pie derecho. Se realizan interconsultas a dermatologia y oftalmologia, que confirman la extensión de la lesión en el paciente del10 % de la epidermis, y la presencia de simbléfaros bilaterales. Se le diagnostica Sindrome de Stevens-Johnson,

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Berger T Skin, Hair, & Nails. In: Tierney L, McPhee S, Papadakis M, editors. Current Medical Diagnosis & Treatment. USA: McGraw-Hill/Appleton & Lange; 2005. p.105.
World Health Organization. WHO Drug Information. WHO Drug Information. [serial on the internet] 2004 [cited 2005 Sep 23] Vol 18, No. 3.[about 2 p.] Available from: http:// whqlibdoc.who.inUdruginfo/18_3_2004.pdf
Estadistica de Reacción adversas medicamentosas según Año, CNFV, 1998-2005. Ministerio de Salud. República de Panamá.
Paul C, Wolkenstein P, Adle H, Wechsler J, Garchon HJ, Revuz J, Roujeau JC. Apoptosis as a mechanism of keratinocytedeath in toxic epidermal necrolysis. Br J Dermatol.1996; 134:71 0-4.
Auquier-Dunant A, Mochenhaupt M, Naldi L, Correia O, Schroder W, Roujeau JC. Correlations between clinical patterns and causes of Erythema multiforme majus, Stevens-Johnson Syndrome, and Toxic Epidermal Necrolysis. Arch Dermatol. 2002;138:1019-24.
Revis JR, Don R. Erythema Multiforme (Stevens-JohnsonSyndrome). eMedicine [serial on the Internet]. June 13, 2005 [cited 2005 Sep 24]. [about 13 p.]. Available from: http://www.emedicine.com/MED/topic727.htm
Stevens AM, Johnson FC. A new eruptive fever associated with stomatitis and ophtalmia. Report of two cases in children. Am J Dis Child.1922;24:526-33.
Roujeau JC, Kelly JP, Naldi L, Rzany B, Stern R,Anderson T, et al. Medication use and the risk of Stevens-Johnson syndrome or toxíc epidermal necrolysis. N Engl J Med.1995;333(24):1600-7.
Lin MS, Dai YS, Pwu RF, Chen YH, Chang NC. Risk estimates fer drugs suspected of being associated with Stevens-Johnson syndrome and toxic epidermal necrolysis: a case-control study. Internal Medicine Journal. 2005;35: 188-90.
Garcia-Dovall, LeCleach L, Bocquet H, Otero XL, Roujeau JC. Toxic epidermal necrolysis and Stevens-Johnson syndrome: does early withdrawal of causative drugs decrease the risk of death? Arch Dermatol. 2000;136:323-27.
Monafo WW. Current concepts: initial management of burns. N Engl J Med. 1996;335:1581-6.
Murphy JT, Purdue GF, Hunt JL. Toxic epidermal necrolysis. J Burn CaMcGee T, MunsterA. Toxic epidermal necrolysis syndrome: mortality rate reduced with early referral to regional burn center. Plast Reconstr Surg. 1998;102: 1018-22.
re Rehabil. 1997;18:417-20.
Peng YZ, Yuan ZO, Xiao, GX. Effects of early enteral feeding on the prevention of enterogenic infection in severely burned patients. Burns. 2001 ;27:145-9
Demling RH, Orgill DP. The anticatabolic and wound healing effects of the testosterone analog oxandrolone after severe bum injury. J Crit Careo 2000;15:12-7.
Demling RH. Comparison of the anabolic effects and complications of human growth hormone and the testosterone analog, oxandrolone, after severe burn injury. Burns. 1999;25:215-21.
Coudray-Lucas C, Le Bever H, Cynober L, De Bandt JP, Carsin H. Ornithine alphaketoglutarate improves wound healing in severe bum patients: a prospective randomizeddouble-blind trial versus isonitrogenous controls. Crit Care Med. 2000;28: 1772-6.
Tanaka H, Matsuda T, Miyagantani Y, Yukioka T, Matsuda H, Shimazaki S. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: a randomized, prospective study. Arch Surg. 2000; 135:326-33.
Romero-Rangel T, Stavrou P, Cotter J, Rosenthal P, Baltatzis S, Foster CS. Gaspermeable scleral contact lens therapy in ocular surface disease. Am J Ophthalmol. 2000; 130:25-32.
Engelhardt SL, Schurr MJ, Helgerson RB. Toxic epidermal necrolysis: an analysis of referral patterns and steroid usage. J Burn Care Rehabil. 1997;18:520-4.
Schulz JT, Sheridan RL, Ryan CM, MacKool B, Tompkins RG. A 10-year experience with toxic epidermal necrolysis. J Burn Care Rehabil. 2000;21 :199-204.
Kelemen JJ, Cioffii WG, McManus WF, MasonADJ, Pruitt BAJ. Bum center care for patients with toxic epidermal necrolysis. J Am ColI Surg. 1995;180:273-8.
Viard 1, Wehrli P, Bullani R, Schneider P, Holler N, Salomon D, et al. Inhibition oftoxic epidermal necrolysis by blockade of CD95 with human intravenous immunoglobulin. Science. 1998;282:490-3.
Furubacke A, Berlin G, Anderson C, Sjoberg F. Lack of significant treatment effect of plasma exchange in the treatment of drug-induced toxic epidermal necrolysis? Intensive Care Med. 1999;25:1307-10.
Frangogiannis NC, Boridy 1, Mazhar M, Mathews R, Gangopadhyay S, Cate T. Cyclophosphamide in the treatment of toxic epidermal necrolysis. South Med J. 1996;89:10013.
Bastuji-Garin S, Fouchard N, Bertocchi M, Roujeau JC, Revuz J, Wolkenstein P. SCORTEN: a severity-of-illness score for toxic epidermal necrolysis. J Invest Dermatol. 2000;115:149-53.by, D.W., Lazar, T. Erythema multiforme exudativum major (Stevens-Johnson syndrome). Lance!. 1951; i: 1091-5.

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[1] Berger T Skin, Hair, & Nails. In: Tierney L, McPhee S, Papadakis M, editors. Current Medical Diagnosis & Treatment. USA: McGraw-Hill/Appleton & Lange; 2005. p.105.

[2] World Health Organization. WHO Drug Information. WHO Drug Information. [serial on the internet] 2004 [cited 2005 Sep 23] Vol 18, No. 3.[about 2 p.] Available from: http:// whqlibdoc.who.inUdruginfo/18_3_2004.pdf

[3] Estadistica de Reacción adversas medicamentosas según Año, CNFV, 1998-2005. Ministerio de Salud. República de Panamá.

[4] Paul C, Wolkenstein P, Adle H, Wechsler J, Garchon HJ, Revuz J, Roujeau JC. Apoptosis as a mechanism of keratinocytedeath in toxic epidermal necrolysis. Br J Dermatol.1996; 134:71 0-4.

[5] Auquier-Dunant A, Mochenhaupt M, Naldi L, Correia O, Schroder W, Roujeau JC. Correlations between clinical patterns and causes of Erythema multiforme majus, Stevens-Johnson Syndrome, and Toxic Epidermal Necrolysis. Arch Dermatol. 2002;138:1019-24.

[6] Revis JR, Don R. Erythema Multiforme (Stevens-JohnsonSyndrome). eMedicine [serial on the Internet]. June 13, 2005 [cited 2005 Sep 24]. [about 13 p.]. Available from: http://www.emedicine.com/MED/topic727.htm

[7] Stevens AM, Johnson FC. A new eruptive fever associated with stomatitis and ophtalmia. Report of two cases in children. Am J Dis Child.1922;24:526-33.

[8] Roujeau JC, Kelly JP, Naldi L, Rzany B, Stern R,Anderson T, et al. Medication use and the risk of Stevens-Johnson syndrome or toxíc epidermal necrolysis. N Engl J Med.1995;333(24):1600-7.

[9] Lin MS, Dai YS, Pwu RF, Chen YH, Chang NC. Risk estimates fer drugs suspected of being associated with Stevens-Johnson syndrome and toxic epidermal necrolysis: a case-control study. Internal Medicine Journal. 2005;35: 188-90.

[10] Garcia-Dovall, LeCleach L, Bocquet H, Otero XL, Roujeau JC. Toxic epidermal necrolysis and Stevens-Johnson syndrome: does early withdrawal of causative drugs decrease the risk of death? Arch Dermatol. 2000;136:323-27.

[11] Monafo WW. Current concepts: initial management of burns. N Engl J Med. 1996;335:1581-6.

[12] Murphy JT, Purdue GF, Hunt JL. Toxic epidermal necrolysis. J Burn CaMcGee T, MunsterA. Toxic epidermal necrolysis syndrome: mortality rate reduced with early referral to regional burn center. Plast Reconstr Surg. 1998;102: 1018-22.

[13] re Rehabil. 1997;18:417-20.

[14] Peng YZ, Yuan ZO, Xiao, GX. Effects of early enteral feeding on the prevention of enterogenic infection in severely burned patients. Burns. 2001 ;27:145-9

[15] Demling RH, Orgill DP. The anticatabolic and wound healing effects of the testosterone analog oxandrolone after severe bum injury. J Crit Careo 2000;15:12-7.

[16] Demling RH. Comparison of the anabolic effects and complications of human growth hormone and the testosterone analog, oxandrolone, after severe burn injury. Burns. 1999;25:215-21.

[17] Coudray-Lucas C, Le Bever H, Cynober L, De Bandt JP, Carsin H. Ornithine alphaketoglutarate improves wound healing in severe bum patients: a prospective randomizeddouble-blind trial versus isonitrogenous controls. Crit Care Med. 2000;28: 1772-6.

[18] Tanaka H, Matsuda T, Miyagantani Y, Yukioka T, Matsuda H, Shimazaki S. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: a randomized, prospective study. Arch Surg. 2000; 135:326-33.

[19] Romero-Rangel T, Stavrou P, Cotter J, Rosenthal P, Baltatzis S, Foster CS. Gaspermeable scleral contact lens therapy in ocular surface disease. Am J Ophthalmol. 2000; 130:25-32.

[20] Engelhardt SL, Schurr MJ, Helgerson RB. Toxic epidermal necrolysis: an analysis of referral patterns and steroid usage. J Burn Care Rehabil. 1997;18:520-4.

[21] Schulz JT, Sheridan RL, Ryan CM, MacKool B, Tompkins RG. A 10-year experience with toxic epidermal necrolysis. J Burn Care Rehabil. 2000;21 :199-204.

[22] Kelemen JJ, Cioffii WG, McManus WF, MasonADJ, Pruitt BAJ. Bum center care for patients with toxic epidermal necrolysis. J Am ColI Surg. 1995;180:273-8.

[23] Viard 1, Wehrli P, Bullani R, Schneider P, Holler N, Salomon D, et al. Inhibition oftoxic epidermal necrolysis by blockade of CD95 with human intravenous immunoglobulin. Science. 1998;282:490-3.

[24] Furubacke A, Berlin G, Anderson C, Sjoberg F. Lack of significant treatment effect of plasma exchange in the treatment of drug-induced toxic epidermal necrolysis? Intensive Care Med. 1999;25:1307-10.

[25] Frangogiannis NC, Boridy 1, Mazhar M, Mathews R, Gangopadhyay S, Cate T. Cyclophosphamide in the treatment of toxic epidermal necrolysis. South Med J. 1996;89:10013.

[26] Bastuji-Garin S, Fouchard N, Bertocchi M, Roujeau JC, Revuz J, Wolkenstein P. SCORTEN: a severity-of-illness score for toxic epidermal necrolysis. J Invest Dermatol. 2000;115:149-53.by, D.W., Lazar, T. Erythema multiforme exudativum major (Stevens-Johnson syndrome). Lance!. 1951; i: 1091-5.

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