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2017 ; 18
(1
): 237
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Warfarin-induced toxic epidermal necrolysis in combination therapy of
Henoch-Schönlein purpura nephritis: a case report
#MMPMID28709416
Kasahara K
; Gotoh Y
; Kuroyanagi Y
; Nagano C
BMC Nephrol
2017[Jul]; 18
(1
): 237
PMID28709416
show ga
BACKGROUND: Toxic epidermal necrolysis (TEN) is a rare life-threatening condition
almost exclusively attributed to drugs. The main etiologic factors for TEN are
sulphonamides, anticonvulsants, and antibiotics; however, there are no published
reports of warfarin causing TEN. CASE PRESENTATION: We present the case of a
3-year-old patient who developed TEN while receiving treatment for
Henoch-Schönlein purpura nephritis (HSPN). With multiple-drug therapy comprising
prednisolone, mizoribine, dipyridamole, and warfarin, it is difficult to detect
which drug is the causative agent. While in most cases, diagnosis of the
causative drug is based on clinical history without a lymphocyte transformation
test (LTT), we performed the test three times and identified the causative drug
as warfarin at the late phase. We continued HSPN treatment without warfarin, and
results showed good renal function without life-threatening complications.
CONCLUSION: To our knowledge, this is the first report about TEN caused by
warfarin. Repeated LTTs could be useful for identifying TEN-causative drugs even
in the late phase.