Reactions Weekly | 2021
Multiple drugs
Abstract
Drug-induced epidermal necrolysis: 4 case reports In a retrospective study of 19 adult patients conducted between January 2015 and December 2019, four adult patients [sexes and exact ages at reaction onset not stated] were described, who developed drug-induced epidermal necrolysis (DIEN) following treatment with carbamazepine, fluconazole, pantoprazole or allopurinol [indications, routes, dosages and durations of treatment to reaction onset not stated; not all reaction outcomes stated]. Among the four patients, 3 patients belonged to the control group and were diagnosed with DIEN. The culprit drugs for causing DIEN was fluconazole (one patient ), pantoprazole (one patient) and allopurinol (one patient). The remaining one patient among the four patients was initially diagnosed with idiopathic epidermal necrolysis (IEN) and passed away later on. During postmortem, LCMS analysis of a blood sample was performed, in which traces of carbamazepine were identified. Thus, the diagnosis of IEN was changed to DIEN after postmortem and carbamazepine was most probably the culprit drug, which led to DIEN, that eventually resulted in death of the patient.