Table 5.
Characteristics of Nine Subjects with DILI who Exhibited Features of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
| Causative Agent | Age/Sex/ Ethnicity |
Latency (days) |
Pattern | Eosinophilia | Peak Serum | Causality score |
Severit y score |
Steroids given |
Outcome | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALT [U/L] |
AP [U/L] |
TBR [mg/dL] |
||||||||||
| 1 | Lamotrigine | 12/F/AA | 34 | HC | No | 862 | 846 | 11.5 | Definite | 3 | Yes | Recovery |
| 2 | Moxifloxacin | 44/M/Asian | 9 | HC | No | 1311 | 379 | 3.6 | Definite | 3 | Yes | Recovery |
| 3* | Diclofenac | 60/F/Asian | 46 | HC | No | 1895 | 303 | 38 | Highly likely |
Fatal | Yes | Fatal (nonhepatic, liver tests improved) |
| 4 | Azithromycin | 11/F/W | 64 | HC | No | 418 | 1112 | 13 | Probable | 4 | Yes | Chronic DILI. Developed Bronchiolitis with bronchiectasis. Died from pulmonary complications |
| 5* | Cefalexin/lamotrigine | 48/F/H | 14 | HC | No | 1808 | 2414 | 59 | Highly likely¶ |
Fatal | Yes | Fatal |
| 6* | Azithromycin | 20/F/AA | 2 | HC | No | 1351 | 718 | 20 | Highly likely |
4 | Yes | Chronic DILI |
| 7 | Lamotrigine | 21/M/W | 13 | HC | No | 1272 | 119 | 0.7 | Definite | 3 | Yes | Recovery |
| 8 | Carbamazepine* | 43/F/W | 30 | Mixed | No | 812 | 1005 | 23.5 | Highly likely |
Fatal | Yes | Fatal (non-hepatic). Liver tests normalized |
| 9 | Nitrofurantoin | 35/F/AA | 7 | Mixed | No | 855 | 678 | 19.8 | Probable | 4 | Yes | Alive at last follow-up |
Abbreviations: AA, African-American; ALT, serum alanine aminotransferase; AP, serum alkaline phosphatase; DILI, drug-induced liver injury; F, female; HC, hepatocellular; M, male; TBR, total bilirubin; W, white; H, Hispanic;
*
these subjects experienced TEN.
¶
104–54 overall causality score was highly likely with cephalexin scored as probable and lamotrigine as possible cause.