Title:Paracetamol-Induced Stevens Johnson Syndrome and Cholestatic Hepatitis
Volume: 10
Issue: 2
Author(s): Raoudha Slim, Neila Fathallah, Amina Aounallah, Mehdi Ksiaa, Badreddine Sriha, Rafiaa Nouira and Chaker Ben Salem
Affiliation:
Keywords:
Cholestasis, drug-induced, eruption, hepatitis, paracetamol, Stevens-Johnson syndrome.
Abstract: Stevens-Johnson syndrome (SJS) is an uncommon life-threatening skin disease, generally
induced by drugs. Extracutaneous manifestations of the syndrome can occur, and may involve the
conjunctiva, buccal mucosa, gastrointestinal and genitourinary tracts. Cholestatic hepatitis has been
rarely described in SJS.
A 29-year-old woman was admitted with generalized cutaneous eruption. A self-medication with paracetamol had been
started three days earlier. Clinical signs and skin biopsy were consistent with SJS. Five days later, the patient developed
jaundice. Serial liver function tests showed rising transaminases, bilirubin, alkaline phosphatase and γ-glutamyl
transferase. Liver biopsy was performed and was consistent with the diagnosis of drug-induced cholestatic hepatitis.
Adequate supportive care was provided to the patient. Skin lesions disappeared within two weeks. Jaundice disappeared
progressively, and liver tests returned to normal.
Herein, we report the first case of SJS associated with cholestatic hepatitis after ingestion of therapeutic doses of
paracetamol.
