Stevens Johnson Syndrome Impacts Young and Old Alike

May 19, 2012, 9:00AM. By Gordon Gibb

Newquay, UKIf there is one thing about Stevens Johnson Syndrome, it is not a respecter of demographics and spares no one, regardless of age. To that end, a young boy in England had his life cut short due to a large extent from the fallout from a disease that affects the skin and replicates a serious burn. On the other end of the scale, an 88-year-old man in otherwise manageable health was cut down by SJS.

Both cases were presumed by medical staff to have been triggered from medication.

The boy was Joe Way, born in England. According to the Cornish Guardian (5/16/12), he came into the world with a rare genetic condition identified by the family on their website as Angelmans syndrome, a condition generally held as survivable. However, at 18 months—having already survived meningitis in his first week of life—the boy was hit with a Stevens Johnson Syndrome rash thought to be drug-related.

"He had experienced bad health throughout his short life," the family writes on their website, "but nothing compares to the horror of SJS."

According to the family, their son was put on a low dose of Topiramate anticonvulsant to help alleviate his tremors. "We were warned about the usual side effects, loss of appetite, liver problems etc, but not SJS. His little mouth was black with ulcers, his hands, feet, neck and face covered in blisters." He was just two years old.

Young Joe Way, from Newquay, beat the odds nonetheless and was beginning to recover from his Stevens Johnson Syndrome symptoms when a viral infection set in, resulting in complete organ failure. His doctors, believing the tot would likely not survive the ambulance trip to hospital in Bristol, advised young Joe's parents to say their good-byes.

"When you're asked to do that, what do you say? Claire and I kissed him and were led to a response car," the boy's father Matt Way said in comments published in the Guardian. "It was so strange watching the ambulance in front carrying our son suddenly turn on the blue lights and the vehicles in front part letting the ambulance disappear."

In the end, the boy miraculously survived complete organ failure, but eventually succumbed to scarred lungs and a severely weakened immune system. He died on May 7, 2008, in his fifth year.

At the other end of the demographic scale, a published article in the medical journal Clinical Geriatrics recounts the case of an 88-year-old patient who, despite various chronic medical conditions, including the recent onset of gout, had ably retained his independence.

Then the patient was diagnosed with Stevens Johnson Syndrome skin disease and he soon wound up in hospital with painful blisters. The SJS was thought to have been triggered by allopurinol, a medication said to have been prescribed by the patient's family physician between one and two weeks prior. By that time 60 percent of the patient's body was affected.

"Besides the newly prescribed allopurinol no other changes had been made to his medication regimen and he had no history of recent infections," wrote Steven R. Gambert, MD, AGSF, MACP Editor-in-Chief, Clinical Geriatrics.

"While Stevens-Johnson syndrome is not commonly encountered in geriatric practice, it remains a sobering example of how quickly someone can develop a life-threatening condition even when they are otherwise well and functional."

The man did not survive his SJS rash, and died soon after arriving in hospital.