Indian Journal of Dermatology
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ORIGINAL ARTICLE
Year : 2020  |  Volume : 65  |  Issue : 4  |  Page : 274-278

Clinical features, risk factors, and prognostic markers of drug-induced liver injury in patients with stevens-johnson syndrome/toxic epidermal necrolysis


1 Department of Dermatology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
2 Department of Biology, Taiyuan Normal University, Taiyuan, Shanxi, China
3 Medical Department of Graduate School, Nanchang University, Nanchang, China
4 Department of Laboratory, The Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi, China
5 Department of Hepatology, The Second Affiliated Hospital of Nanchang University, Nanchang, China

Correspondence Address:
Ougen Liu
Department of Dermatology, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Nanchang, Jiangxi, 330006
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijd.IJD_217_19

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Background: The liver and skin are the most common organs involved in Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). Drug reactions rarely affect both organs concurrently. The clinical features, risk factors, and prognostic markers of drug-induced liver injury (DILI) in patients with SJS/TEN are not well studied. Materials and Methods: The clinical features, risk factors, and prognostic markers of DILI in patients with SJS/TEN hospitalized at the dermatology department of our hospital from January 2009 to December 2018 were retrospectively analyzed. Results: A total of 298 patients with SJS/TEN were enrolled in this study. Of them, 40 had liver injury and the rest served as control. Causative drugs mainly included antipodagrics (xanthine oxidase inhibitors occupying 100% among antipodagrics), anticonvulsants (dibenzazepine occupying 76.92% among anticonvulsants), and traditional Chinese medicines. There was a statistically significant difference between the patients with liver injury and the control group in the history of liver disease, diabetes, and hyperlipidemia (P < 0.05). Nine of the 40 patients with liver injury died. High serum total bilirubin and creatinine levels were significantly associated with poor prognosis of DILI in patients with SJS/TEN (P < 0.05). Conclusion: DILI usually occurs in patients with SJS/TEN. Pre-existing liver disease, diabetes, and hyperlipidemia are independent risk factors for DILI in patients with SJS/TEN. High serum total bilirubin and creatinine levels may be useful prognostic markers for DILI in patients with SJS/TEN.


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