ESPE Abstracts (2015) 84 P-3-634

Autoimmune

Stevens Johnson Syndrome in a Case with Type 1 Diabetes Mellitus: Relation or Coincidence?

Onur Akin, Esra Doger, Emine Demet Akbas, Arzu Bakirtas, Orhun Camurdan, Aysun Bideci & Peyami Cinaz

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Faculty of Medicine, Gazi University, Ankara, Turkey


Background: Stevens-Johnson syndrome (SJS) is an acute life-threatening dermatosis characterised by conjunctivitis, oral ulcerations, fever, and erythematous macules. The most important etiological factors are infections and drugs including anticonvulsants and nonsteroidal anti- inflammatories.

Objective and hypotheses: Cases with both SJS and type 1 diabetes mellitus have been reported rarely in the literature. Herein, we report a diabetic case of recurrent SJS due to different causes.

Method: A 10-year-old boy was admitted to our department with a 3-day history of fever, oral mucosal ulcerations and skin lesions. The patient was not under any treatment apart from insulin. He was diagnosed with type 1 diabetes 4 months ago. He has history of SJS with amoxicillin 3 years ago and clarithromycin 4 years ago. Physical examination revealed oral mucosal ulcerations, haemorrhagic crust on the lips, and bullose lesions on his thrunk and penis. Laboratory tests, including CBC, serum electrolytes, liver and renal function tests, urine analysis and sedimentation rate were within normal limits. Chest radiography was also normal. Mycoplasma PCR was negative.

Results: The patient was diagnosed with unknown origin SJS and treated with methylprednisolone. The lesions progressively resolved in 5 days and methylprednisolone therapy was terminated.

Conclusion: Type 1 diabetes mellitus is an autoimmune disease and associated with other autoimmune disorders such as thyroiditis and cealiac disease. SJS also occurs due to immune system defects. SJS may be associated with type 1 diabetes. New reports are required to define whether this association is a possible link in pathogenesis or coincidence.

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