4.3 Article

Ibuprofen induced Stevens-Johnson syndrome and liver injury in children: a case report

Journal

TRANSLATIONAL PEDIATRICS
Volume 10, Issue 6, Pages 1737-1742

Publisher

AME PUBL CO
DOI: 10.21037/tp-21-8

Keywords

Case report; Stevens-Johnson syndrome (SJS); liver damage; drug gene testing

Categories

Funding

  1. Shanghai Jiao Tong University Key Laboratory of Genetic Development and Mental and Neurological Diseases of Ministry of Education [2020GDND01]
  2. Science Popularization Research Project of National Medical Economic Information Network of Chinese Pharmaceutical Association [CMEI2021KPYJ (JZYY) 00202]
  3. Clinical Pharmacy Innovation Research Institute of Shanghai Jiao Tong University School of Medicine [CXYJY2019MS003]

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Stevens-Johnson syndrome (SJS) is a disorder that causes severe damage to the skin and mucous membranes, often drug-related. Liver injury caused by ibuprofen is usually associated with overdose, with rare instances from normal doses and individual variations in different situations. Studies suggest a relationship between drug-induced liver injury (DILI) and human leukocyte antigen (HLA) genotyping.
Stevens-Johnson syndrome (SJS) is a disorder that causes severe damage to the skin and mucous membranes with bullous and erosive properties. Drug-induced liver injury (DILI) is closely related to non-steroidal anti-inflammatory drugs (such as ibuprofen). Liver injury caused by ibuprofen is often related to overdose, and liver injury caused by normal dose is rare, and there are individual differences in different situations. In this case, a child developed SJS and acute liver injury after treatment with ibuprofen suspension. We described the characteristics of related adverse reactions induced by ibuprofen, and analyzed the relationship between SJS caused by the drug and related drug genes. Glucocorticoids and antihistamines were used to treat dermatitis, reduced glutathione (GSH) to protect the liver and plasma exchange detoxification. Finally, the patient's dermatitis healed and the liver injury was significantly improved. Many studies have suggested that DILI may be related to human leukocyte antigen (HLA) genotyping. The detection of drug-related genes revealed that the SJS and liver damage caused by ibuprofen might have been related to the positive HLA-B*5801. This article suggests that attention should be paid to checking liver function indicators after taking ibuprofen, and genetic screening can be used to reduce the risk of generelated adverse reactions when necessary.

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