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Stevens Johnson Syndrome

Stevens Johnson Syndrome (SJS) is typically caused by a severe allergic reaction to a medication. SJS usually begins with a Stevens Johnson Syndrome rash that can lead to blistering, severe peeling and open sores. Other Stevens Johnson syndrome symptoms include infections caused by the loss of skin or scarring of major organ systems that can be life-threatening. Often an SJS rash is not diagnosed in time, and the condition becomes life-threatening.

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Stevens Johnson Syndrome

Stevens Johnson Syndrome (SJS), also known as Erythema Multiforme, Leyll's Syndrome, and in its later stages, Toxic Epidermal Necrolysis (TEN), is a serious and potentially life-threatening disease that causes large areas of the skin to become detached and lesions to develop in the mucous membranes.

Pharmaceutical manufacturers are aware of the risks associated with their drugs, yet proper warnings are for the most part inadequate. Many over-the-counter (OTC) drugs such as Ibuprofen—found in Advil and Motrin—have been linked to SJS. Without adequate warnings, patients who develop SJS may continue to take the SJS-causing drug, which could lead to TEN.

SJS Medications

SJS is caused by almost any medication, including antibiotics, anticonvulsants, sedatives and painkillers. The leading causes of this disease are the following medications:
  • Ibuprofen (Advil, Children's Advil, Motrin, Children's Motrin and Nuprin)
  • Bactrim, a sulfa drug
  • Ketek, an antibiotic
  • Dilantin, an anticonvulsant
  • COX-2 inhibitors Bextra (Valdecoxib),Vioxx (Rofecoxib), Celebrex (Celecoxib), and Non Steroidal Anti-Inflammatory Drugs (NSAID's) including Daypro (Oxaprozein)
  • Non Steroidal Anti Inflammatory drugs such as Feldene (Piroxicam), Naproxen (Aleve)
  • Leavquin (levofloxacin) , belonging to a class of drugs called fluoroquinolones, the antibiotic is used to treat bacterial infections such as pneumonia, bronchitis, sinus, skin, and urinary tract infections.
In May, 2006 the FDA updated several prescription and over the counter (OTC) medications with a warning label as a result of increased risk of developing Steven's Johnson Syndrome. The following drugs had either a new warning regarding SJS or additional wording:
  • Tolectin 600 Tablets (Tometin Sodium)
  • Tolectin DS Capsules (Tometin Sodium)
  • Advil Allergy Sinus Tablets (200 mg ibuprofen / 30 mg pseudoephedrine HCI / 2 mg chlorpheniramine maleate)
  • Advil Cold & Sinus Tablets (200 mg ibuprofen / 30 mg pseudoephedrine HCI)
  • Advil Liqui-Gels (200 mg ibuprofen capsules)
  • Advil Migraine Capsules (200 mg ibuprofen)
  • Children's Motrin Chewable Tablets (50 mg ibuprofen)
  • Motrin Junior Strength Chewable Tablets (100 mg ibuprofen)
  • Motrin Cold & Sinus Tablets (200 mg ibuprofen / 30 mg pseudoephedrine HCI)
  • Motrin IB Tablets (200 mg ibuprofen)
  • Motrin Infants' Drops (50 mg / 1.25 mL ibuprofen oral suspension)
In December 2007 an FDA Alert added Carbamazepine (marketed as Carbatrol, Equetro, Tegretol, and generics) to be at risk for SJS, particularly affecting Asian and South Asian patients.

In June 2011 the New England Journal of Medicine (Health Policy and Reform) reported that the FDA published a regulation (September 2010, implemented as of March 2011) establishing a new safety-reporting paradigm for drugs being studied under investigational new drug applications (INDs). It is the first step in a series the FDA is taking “to enhance the protection of human subjects and improve trial conduct by streamlining the regulatory procedures for clinical trials”. Regarding SJS, the researchers say that, “Not only is SJS unexpected and serious, it is known to be strongly associated with drug exposure. A report of SJS would clearly be informative about the safety of the investigational drug and could have important effects on patient monitoring and care”.

Stevens Johnson Syndrome Symptoms

sjsStevens Johnson Syndrome symptoms can begin with a fever, sore throat and headache and over a few days (or sometimes even minutes) can turn into skin lesions and blisters and respiratory infection. It generally affects the mucous membranes of the mouth and throat and swelling of the eyelids, and can progress to blindness and internal organ damage.

As Stevens Johnson Syndrome evolves, the skin literally sloughs off in sheets. Patients are typically treated in a hospital's burn unit. If the skin lesions become infected, or the patient develops lesions in the lungs, it can result in death (which results in about 5-15 percent of cases).

In approximately 5 to 15% of the severe occurrences of SJS, the patient may die as a result.  The patient’s skin literally burns from the inside out and often requires treatment in an intensive care unit (ICU) or the burn unit of a hospital.

Recognizing early symptoms of SJS and providing prompt medical attention are the most valuable tools to minimize long-term damage.

Who Is at Risk for Stevens Johnson Syndrome?


Allergic drug reactions cause more than 100,000 deaths among patients in the United States each year, and adverse drug reactions are the leading causes of death in the US. Every day, more than 4,000 patients—approximately 1.5 million per year—are admitted to hospitals with serious adverse drug reactions. Many of these admissions can be prevented. RN Patient Advocates reports that 18.6 percent of all drugs prescribed prior to hospitalization were contraindicated (i.e., the drug in question should not have been taken).

Those patients most likely to develop Stevens Johnson Syndrome are extremely allergic to antibiotics or painkillers like Ibuprofen. Most cases occur in adults between the ages of 20-40 years, but SJS has been diagnosed in children as young as three months old. Anyone who takes prescription or over-the-counter (OTC) drugs runs the risk of developing allergic reactions and developing serious health problems like Stevens Johnson Syndrome.

Stevens Johnson Syndrome Lawsuits

Stevens Johnson Syndrome attorneys are currently reviewing and working on SJS cases for "failure to warn." Many drugs, including generic drugs associated with SJS have inadequate warnings on the product labels. If a drug has a black-box warning, SJS attorneys may consider a medical malpractice lawsuit.

Register your Stevens Johnson Syndrome Case

If you or a loved one has suffered from Stevens Johnson Syndrome, you may qualify for damages or remedies that may be awarded in a Stevens Johnson Syndrome class action or lawsuit. Please click the link below to submit your Stevens Johnson Syndrome complaint to an attorney who will review your claim at no cost.
Last updated on May-13-14

STEVENS JOHNSON SYNDROME (SJS) LEGAL ARTICLES AND INTERVIEWS

Antidepressants Blamed for Stevens Johnson Syndrome
Antidepressants Blamed for Stevens Johnson Syndrome Detroit, MI: The use of antidepressants has been blamed for a mother developing Stevens Johnson Syndrome (SJS) and almost ending her life. The woman, who was prescribed antidepressants to treat depression and post-traumatic stress disorder, was ultimately hospitalized in intensive care with SJS symptoms [READ MORE]

Nigeria Issues Stevens Johnson Syndrome Alert
Nigeria Issues Stevens Johnson Syndrome Alert Washington, DC: Highlighting how little is still understood about Stevens Johnson Syndrome (SJS), officials in Nigeria issued an alert, warning patients to be careful of their medication use after reports of a Stevens Johnson Syndrome-related death. Africa News (5/14/16) reports that officials warned patients that SJS is often a reaction to medication or an infection [READ MORE]

Woman Survives Stevens Johnson Syndrome Ordeal
Woman Survives Stevens Johnson Syndrome Ordeal Miami, FL: Patients taking medications are aware there are side effects to watch out for, but they may not realize that some medications come with a risk of a life-threatening condition known as Stevens Johnson Syndrome. Lawsuits have been filed against drugmakers, doctors, and other health care providers, alleging patients were not adequately warned about the risk of the serious condition, which can leave survivors permanently scarred and disabled [READ MORE]





READER COMMENTS

Posted by
Nancy
on
My mother, who was 87, was prescribed keflex for an infection in her artificial knee. After over 16 days on the meds, she developed flu like symptoms and a rash. I had called the doctor's office twice before this happened, and asked them why they did not want to have a list of her medications she was on. The first time I was told they counted on the pharmacy to say if there was a reaction. The second time, after she was feeling ill do to the antibiotics, I was told to have her family doctor send over a list. I did this both times. She did not take the antibiotic that the pharmacist said would have a reaction. The other antibiotic made her sick to her stomach. So the doctor switched her to Keflex. Ater over 16 days she was ill. She stopped the meds, called the doctor, who agreed. Two days later I took her to the doctor. She was worse. He looked at her, said that it was a reaction to the meds, said it was rare to have it happen after this long on the medication. He said to never take an antibiotic again. Said she would have to "deal" with the knee. Said "we don't want to kill you". Never touched her. Never looked into anything further. Told me to get Benedryl. Gave her a script for five days of prednisone. Twenty days later, my mother was dead of Stevens Johnson Syndrome.

Posted by
Ron Cobb
on
I had shoulder surgery on my right shoulder in 2008 and then reinjured it and a January ice storm in 2016. My doctor prescribed 120 800 milligram ibuprofen for me. The amount taken was to be morning noon and night but knowing I'm sensitive to drugs I just took them in the morning to get through the day and at night to sleep because of the pain in my right shoulder. My cousin noticed a little spot under my right eyelid which in one day grew to be an inch long bright red. I immediately took myself off of ibuprofen and after several days the rash went away but there is no question in my mind it was directly related to the ibuprofen since I am also allergic to penicillin and penicillin related antibiotics. I am very glad I caught it early because I constantly read about the medication I am taking.

Posted by
Mary Ann Town
on
I am a SJS survivor from 1999 and I stayed in the hospital for over a week with a life threatening condition from Daypro.. When a doctor tell the nurses to make a patient as comfortable as possible because they will probably die in 2days..I know for a fact that God is real because he spared my life..I still have some complications withy vision and extremely dry skin and so often I have sick spells but glory be to God.,. Anyone that have suffered from SJS need to be reward from the drugs that caused some of us to survive and some died,no matter how long its been.what lawyer will take the risk and help.I need a fighter on my side!!! Thank You.

Posted by
Ricardo Vasquez
on
8/5/2015 I was prescribe Bactrim, the pharmacy didn't have it available until 8/8/2015 A drug I have never took in my life. I'm 35 yrs old and been over seas, US ARMY VETERAN. out of all the doctors I get one that said this's will help your skin infection. About 15 days later I get burning sensation in my eyes and blisters in my mouth. What gets me is if it's a allergic reaction it should happen the first dose. But 15 days later that's something crazy! I went to the nearest hospital Dekalb Medical on 8/25/15. They said as soon as I arrived to the ER I had Steve Johnson syndrome. So Tuesday all day, Wednesday all day, Thursday all day. No improvement , I was dying the blisters multiplied by 100% and I couldn't wen swallow anymore. Friday they decided to send a Ambulance to take me to Grady Hospital Burn unit ! I am thankful to the Doctors there ! The went immediately to work. I just remember the first hour of arrival when the where cutting the blisters in my mouth or something of that sort. Then I woke up with a awake tracheostomy for me to breathe while they worked to Heal me. Blisters on my face legs arms and midsection ! I'm scars all over. Weak , and recovering ! It's tough to experience and either the pharmaceutical company needs to take responsibility ! 15 days is too long for a sorry you may get Steve Johnson Syndrome. I'm mentally emotional at times but awareness is important and maybe that pharmaceutical should just stop making Bactrim.
Ricardo Vasquez
Love kept me alive
God kept me alive
Good Doctors keeping me alive

Posted by
Randolph R Perry Sr
on
My wife has been diagnosed with SJS which has evolved to TENS,she had to be transported to a burn center in Georgia and is now on a ventilator,feeding tube and 24hr dialysis;she is on max level with the medications but her body isn't responding properly to the meds,her organs are trying to quit. It's been a week since I've heard my wife's voice and I would give anything to trade places with her or ease her suffering.My wife has been a dialysis patient for the past 8 yrs but shes never lost her faith in God and her love for life,always maintaining a strong spirit. So I'm struggling with the decision of whether my wife would want me to pursue legal action against this very prestigious hospital in NC where she had internal imaging done but excessive contrast was used,which she is highly allergic to(uncertain of what other drugs were used)but I do know that they prescribed prednisone on the day before the procedure to counteract the allergic reaction,But something went terribly wrong...IF THERE IS ANYONE OUT THERE THAT CAN GIVE ME SOME SENSIBLE ADVICE PLEASE

Posted by
Debbie
on
I am fortunate after hip surgery I was prescribed 500mg Naproxen as an anti-inflammatory after the second day of starting the medication I felt tingling, burning and itching but ignored it. I then noticed swelling in my legs and became concerned of a possible clot. called the surgeon and went to the ER but took my night meds prior to going. By the time I had gotten their my hands started swelling, while sitting in the ER trying to get the doctor to even look at my hands and not just be focused on a clot, I developed some chest pain and the glands on my right neck, blisters started developing on my hands and feet and became bright red by the time I was admitted upstairs. I pointed all of this out to the floor doctor and was later brought in by the nurse Naproxen and a blood thinner. Being a nurse myself I refused them and abruptly left the hospital and went home and took Benadryl for the next three days. However I had never heard of or had seen SJS in any of my patient contacts. I was certain it was an allergic reaction and not a clot, however; I did not know it was the naproxen because I had also started Plavix at the same time. so when the rash went away I tried the naproxen first. My mistake I had an immediate return of itching within an hour of taking it so I took a dose of Benadryl and thru the medication away. When I returned to the surgeons office to have the sutures removed I explained my symptoms and he immediately told me what it was.

Posted by
Missouri
on
Blistering all over my body, blurry vision.

Posted by
Oklahoma
on
I was diagnosed with SJS/TEN in 2010 and nearly died. Now I suffer from so many long-term conditions (blindness, scarring, arthritis, lung damage, nerve damage, etc) that I am on disability and am unable to work. Because of this, I have financial difficulties and have to have a personal care assistant live with me. My life has been changed drastically and will never go back to the way it was.

Posted by
California
on
In hospital for 3 weeks, 10% of skin dislocation, still have the scars. Also diagnosed with neuropathy one year later - the drug I was prescribed had a black box warning out 2 months before I was prescribed it.

Posted by
Oklahoma
on
Zithromycin, and Omnicef caused me to be legally blind; extreme sensitivity to sun and heat. Destroyeed tear ducts, abnormal fatigue, recurring pneumonia, PTSD, anxiety, lack of sleep, overall nerve damage, trouble concentrating. Extreme skin sensitivity. Need help with daily chores.

Posted by
Texas
on
I am a 36 y/o female who unexpectently went into respiratory distress due to blistering of the lips, mouth, swelling of the tongue, that progressed into a complete body rash with extreme dryness, swelling and redness of the eyes. Then abnormal MRI of the brain.

Posted by
New York
on
Severe allergic reaction to Motrin, which burned my body from the inside out.

Posted by
Idaho
on
I was given a generic form of Bactrim 800 for a urinary tract infection. I had never had any allergic reaction to anything, so when I started to hallucinate, I didn't think anything of it. I then started falling all over the place. After six days I ended up in the hospital with a rash all over my body. I have no memory of the Sunday before I went to hospital or the first 4 days that I was in the hospital. When I woke up, my entire body was as red as a lobster. It burned and it itched like crazy. I was very disoriented. I could barely stand on my own. I was in the hospital until the next Monday and was sent home with oxygen and a walker. To this day I still have bouts of disorientation and occasionally have trouble standing up. My skin still burns but I have no rash.

Posted by
Texas
on
Stevens Johnsons has caused my son to have severe eye irritation and redness; Mouth and throat soreness and swelling, which limits his ability to eat; His physical ability also has been limited and he sleeps the majority of the day. He has to learn how to walk and eat all over again. My son's physical appearance has also been impacted, 1st layer of skin removed and some of his hair came out. He does not look like himself and he can only go outdoors for limited amounts of time, due to the sun irritating his eyes. SJS has really hit my son hard and I am thankful to God that he is still alive. He is only four, but he has a heart of a champion. He also has to miss the remainder of Pre-K for the school year, due to this illness.

Posted by
California
on
My son was diagnosed at 3 with SJS/TEN. He is 8 now but still has limitations.

Posted by
Illinois
on
My son had an allergic reaction when taking lamictal and motrin. He swelled and had a rash. His eyes were swollen shut. He was in the hospital for a week and in icu when his blood pressure dropped. He was diagnosed with SJS. His skin peeled off like a burn. He has since recovered but I am not sure about any other effects. He was hospitalized a second time after for swelling but had a less severe case. I am worried that the medicine he currently takes (prozac, abilify, methalyn) will interact again with other over-the-counter treatments for common illnesses children may come down with, such as a cold or flu.

Posted by
Kentucky
on
She was admitted to Kosairs in Louisville and diagnosed with sjs/ten....blisters/peeling over 30 percent of her body.

Posted by
California
on
Chris is hospitalized to where he almost died. He was on his way into full cardiac arrest ,covered with scabs, on a respirator, a feeding tube in his stomach.

Respiratory problem, skin disorder, blurred vision. Were told feet may have to be amputated, on breathing machine to a tube in his throat. Lost 45lbs.

Posted by
Alabama
on
Hospitalized for 17 days for skin melting off. Had severe pain, stomach sickness, loss of appetite/weight, and severe itching. Have pictures after three weeks of being treated. I almost died because of this. It happened about four months ago.

Posted by
Alabama
on
Toxic epidermal necrolysis.
Stephen johnson syndrome.

Posted by
Ontario
on
Rash all over the body with blisters. Painful itchy sensation in the skin and scalp. Pain when swallow .

Posted by
Florida
on
Skin lacerations, rashes, eye infections (eyesight permanently affected), bleeding.

Posted by
South Carolina
on
Steven Johnson syndrome with rash head to toe, Skin peeling on feet & hands, skin problems in various places on the body, Mucousal blisters, GI irritation and possibly ulcers, eye sight changes. I've lost time from work & have been taking FMLA as well. I can only eat yogurt & mashed potatoes. I've lost 14 lbs thus far. The reaction started on April 29th 2012.

Posted by
North Carolina
on
Multiple internal and external burns all over the body and loss of vision.

Posted by
Ontario
on
Eye problems, facial discoloration and skin.

Unable to describe well. Would like to speak with someone pls.

Posted by
North Carolina
on
My skin burnt off all over my body, everywhere but my face, thank goodness. When recovering from that, I ended up needing emergency surgery, had to have my lympnods cleaned out, had a bad infection, ended up being mercer, from my immune system being weak.

Posted by
Arizona
on
After 1 week I woke up with a fever of 104 degrees, my skin looked as if I had a bad sun burn. I had a cough and my glands were swollen on my neck. My skin was painful to touch. My doctor treated me with antibiotics saying I was just "sick" and the drug did not cause my symptoms.

Pain, out of work for a week.

Posted by
Florida
on
I was given a sulfa drug, even though the doctor was aware I was allergic to it. I had a burn like rash on my face, eyes, neck. and arms. Doctors caught it before it spread over my entire body. I had sores in my nose, throat and eyes.

Posted by
Texas
on
I was never told there could be a rash or anything. Within 2 weeks I developed SJS and was hospitilized for 6 days. I could not breathe and my entire body was covered in rashes and blisters, I have not been able to eat and have lost over 15 pounds and have suffered more pain and suffering than one should have to endure.

I have permanent skin discolorization, scarring on my arms and legs. I have massive blisters on the bottoms of my feet preventing me from being able to walk for long period of times.

Posted by
New York
on
SJS...The reaction was so bad that when I walked into the Emergency Room the ER nurse looked at me and said SJS.

Posted by
Washington
on
I was diagnosed with Steven Johnson Syndrome in March of 2007. Along with SJS I also had liver failure and developed pneumonia while in the hospital. It was discovered that it was caused by Lamictal, a drug I was taking for my Bi-Polar disorder. I was hospitalized for two weeks and it wasn't until a few days before I was released and a liver biopsy that they discovered that my liver had failed and that I had Steven Johnson Syndrome. I had been taking Lamictal and had been instructed to take the medication all the way up until the time that they discovered what was causing my symptoms. Two weeks after taking the medication I noticed I had little red bumps forming on the base of my feet, and within another three weeks they had spread throughout my body, including inside my mouth and down my throat. They burned and were extremely painful and sore.

Posted by
Tennessee
on
Fortunately my reaction wasn't as severe as some that I have read. However, I felt it was important to let someone know in an attempt to get this product off the market. I had an almost immediate reaction from Bactrim, 2 pills is all it took to set my face on fire. I described it to my family and work as a 2nd degree burn feeling. (Being from Florida I know this burn) My face was swollen and bright red, my body itchy, and it caused pain in my entire body that made it impossible to sleep it off. These symptoms caused sleepless nights and time missed from work. I contacted my Physician and left a message regarding this reaction and to my disappointment never received a return call from him or the office. A major disappointment! Upon which case I contacted a friend of mine who is a licensed paramedic that suggested trying Benadryl to subside the reaction. After consistently taking Benadryl for a couple days my symptoms subsided. It has now been almost a week since this has happened and since my face and lips have been peeling and still remains to do so. I seem to finally be in recover mode. I hate to think of what would have been had I taken just one more pill!!

Posted by
Washington
on
On my 7th day taking Bactrim I woke with diarrhea and had that all morning and afternoon (10 times). Then I got hives all over my body that night and they got worse and worse throughout the night. I went to the ER and he said I should just take benadryl. I did and went to bed. When I woke, my lips were 10 times bigger than normal, my eyes had black circles and puffiness, the rest of my face was puffy, I felt like I was going to faint and the rest of my hives were even bigger and there were more. I went to the ER a second time because my throat was starting to close up and I could not breath well - I was scared because I thought it might close completely. They gave me an iv with solvnedral, pepcid, benadryl and ativan. While in the hospital I noticed my forehead felt warm and when I touch it the skin hurts (not a headache), my face swelled up, dark around eyes, my blood pressure was 77/43 and it has never been that low (normal is 80-90/60). My chest started having pains, my hands started to ache, my temp was 99.9. So I am convinced I am going to miscarry or have birth defects because of Bactrim and what it did to me (and additional medicines I had to take because of it).

Posted by
Virginia
on
Prescribed Bextra by Pain Mgmt MD. Experienced skin reaction of huge liquid filled blisters over torso of my body. Also, experienced complete and sudden cessation of menstrual periods. I reported the above to prescribing MD who immediately dismissed any possibility of causal relationship and insisted that blisters were a result of burns from sleeping with heating pad (pain tx utilized for past 20 years). Dismissed menstrual cessation as "something to be expected with a female of your age." I was in my late 40's and internist had recently advised me that based on blood work results that I "was not even close to menopause." I was not satisfied with the MD explanation & given the lack of pain decrease response I opted to d/c Bextra on my own. Also, I referred to print-out from pharmacy which warned of SJS side effect including potentially fatal outcome. Reported concerns at later time to other MD's. Dr. Rosenthal (allergist), unlike other two doctors, took the time to look Bextra up on his medical info site. He reported that both side effects are indeed documented as potential response to Bextra & supported my consumer awareness & d/c of med in light of disinterested and/or ignorance of prior medical advice. Large assymetrical fluid filled blisters which caused considerable pain both before & after release of underlying fluid; cessation of menstrual periods. Long-term but eventual resolution of scarring from lg. fluid filled blisters.

Posted by
California
on
Hello, I have a sister who has SJS with Her2 Breast Cancer. The HMO she has will only treat for her Cancer, but will not treat her for the SJS. She been fighting the HMO to get treatment for both her health problems. One of the HMO Doctor told her if she got treatment for the cancer that the SJS would get to the point that she would be bed ridden or in a wheel chair because the cancer treatment would only make the SJS intensify.

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