Original articleApoptosis in ibuprofen-induced Stevens–Johnson syndrome
Section snippets
Case report
A 7-year-old African-American girl was hospitalized with rash, pruritus, and fever. Previously, the girl was given ibuprofen, as medication for fever. Viral determinations showed no signs of viral infection. The vesicular eruptions became bullous, coalescent, and led to desquamation of the skin. Based on the clinical manifestation, the hospital dermatologist made the diagnosis of SJS. A biopsy was taken during the SJS episode. During the hospitalization she developed high alanine
Results
In controls, LTA shows normal ranges of toxicity for ibuprofen. This patient presented a high level of cytotoxicity to ibuprofen as compared with controls with a result of 33%. The normal level or cut-off for this ibuprofen-LTA on patients is 15% (10 ± 5). In immunocompetent individuals found to have SJS or TEN, the LTA ranges between 24% and 35%. The immunocompetent person is defined as not presenting acquired or hereditary immunodeficiency, and as not being under immunosupressive drugs or
Discussion
Current investigations contribute to the understanding of the underlying adverse drug reaction that caused the SJS/TEN, providing clues to their immunopathogenesis.
Clinical symptoms of rash, fever, and organ involvement that occur in HSRs and specifically in a patient’s TEN may be due to the involvement of cells such as neutrophils, monocytes, and macrophages, as well as to specialized cells such as keratinocytes. However, excluding neutrophils, these cells are also antigen-presenting cells and
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