What Triggers Stevens Johnson Syndrome and Why? The Debate Continues

November 21, 2010, 8:00AM. By Gordon Gibb

Palo Alto, CAIt's a foregone conclusion that Stevens Johnson Syndrome is caused by allergic reaction to medication. While it depends on the individual—one person can consume the same over-the-counter (OTC) pain medication as another and not succumb to SJS symptoms, while the other may—the fact remains the rare skin disorder is triggered by adverse reactions to medication such as Motrin.

And the more medicines we take, for everything from a headache to arthritis, the more susceptible we are to potential reactions.

With that in mind, efforts have always focused on identifying which specific medicines trigger Stevens Johnson Syndrome rash, and an individual's susceptibility to it. According to Benzinga.com on November 17th, the US Food and Drug Administration (FDA) has determined that certain individuals who test positive for the leukocyte antigen (HLA) allele, HLA-B*1502 in their DNA should avoid treatment with carbamazepine for epilepsy, trigeminal neuralgia and bipolar disorder. Neither should these individuals be treated with phenytoin or fosphenytoin for seizures.

There is a greater risk in these populations for developing Stevens Johnson Syndrome symptoms.

To that end Benzinga.com reports that Pharmigene has licensed both patented and patent-pending intellectual property to the Mayo Clinic for the development of in-house genetic testing with the view toward detecting key genetic alleles in individual patients. Avoiding treatment with certain drugs linked to Stevens Johnson Syndrome skin disease and TENS could prove a lifesaver for individuals who are at greater risk than the general population.

It was noted that several scientific studies have found that patients with the HLA-B*5801 allele could also be at higher risk for developing SJS rash if they are treated with allopurinol therapy for hyperuricemia. Allopurinol is also used to treat reduceuric acid level in patients receiving cancer chemotherapy, and also used to treat certain types of kidney stones.

Various SJS lawsuits have stemmed from cases where patients unaware of risk factors for the skin disease have encountered grievous symptoms after taking various medications. SJS is no respecter of age or demographic, with heartbreaking stories of children suffering from horrific blisters and skin lesions—together with eye problems—simply from taking a spoonful of OTC pain medication for a toothache. As much as the FDA is attempting to increase knowledge and oversight into what triggers SJS and in whom, lawsuits continue to be filed—keeping Stevens Johnson Syndrome lawyers busy.