PMID- 33546081
OWN - NLM
STAT- MEDLINE
DCOM- 20210215
LR  - 20220420
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 100
IP  - 3
DP  - 2021 Jan 22
TI  - Toxic epidermal necrolysis in a patient on atorvastatin therapy expressing human 
      leukocyte antigen alleles: A case report.
PG  - e24392
LID - 10.1097/MD.0000000000024392 [doi]
LID - e24392
AB  - RATIONALE: Toxic epidermal necrolysis (TEN) is a rare, severe mucosal response of 
      the skin associated with a high mortality rate. TEN is most commonly caused by 
      drugs, and is characterized by extensive skin epidermal exfoliation. PATIENT 
      CONCERNS: A 68-year-old woman presented with a rash that had persisted for four 
      days. The patient who had undergone a mitral valve replacement 1 month prior and 
      was taking atorvastatin at the time of admission. DIAGNOSES: The patient 
      exhibited more than 30% exfoliation surfaces and the severe drug eruption was 
      considered to be TEN. According to human leukocyte antigen (HLA) allele detection 
      and ALDEN score, HLA alleles which found in this case report may be an cause of 
      TEN induced by atorvastatin. INTERVENTIONS: All drugs used prior to admission 
      were discontinued and the patient was given antiallergic drugs. OUTCOMES: After 
      3 weeks following Antiallergic treatment, the rash on patient's calf had 
      subsided, the edema was relieved, and the patient was no longer experiencing 
      pain. After 60 days following discharge, the patient's skin has regrown. LESSONS: 
      This is the first report describing the induction of TEN by atorvastatin in a HLA 
      alleles carrier. For HLA alleles carrier, atorvastatin may need to be used with 
      caution to avoid TEN. Future systematic research is also required to confirm this 
      finding and avoid similar serious skin adverse reactions.
CI  - Copyright (c) 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Lv, Meina
AU  - Lv M
AD  - Department of Pharmacy, Fujian Medical University Union Hospital.
AD  - College of Pharmacy, Fujian Medical University, Fuzhou, Fujian.
FAU - Jiang, Shaojun
AU  - Jiang S
AD  - Department of Pharmacy, Fujian Medical University Union Hospital.
AD  - College of Pharmacy, Fujian Medical University, Fuzhou, Fujian.
FAU - Fu, Jinglan
AU  - Fu J
AD  - Department of Pharmacy, Fujian Medical University Union Hospital.
AD  - College of Pharmacy, Fujian Medical University, Fuzhou, Fujian.
FAU - Liu, Yuxin
AU  - Liu Y
AD  - Department of Pharmacy, Fujian Medical University Union Hospital.
AD  - Department of Pharmacy, Huaihe Hospital of Henan University, Kaifeng, Henan, 
      China.
FAU - Lian, Siheng
AU  - Lian S
AD  - Department of Pharmacy, Fujian Medical University Union Hospital.
AD  - College of Pharmacy, Fujian Medical University, Fuzhou, Fujian.
FAU - Zhang, Jinhua
AU  - Zhang J
AD  - Department of Pharmacy, Fujian Medical University Union Hospital.
AD  - College of Pharmacy, Fujian Medical University, Fuzhou, Fujian.
LA  - eng
GR  - 2018Y0037/Natural Science Foundation of Fujian Province of China/
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (HLA Antigens)
RN  - A0JWA85V8F (Atorvastatin)
SB  - IM
MH  - Aged
MH  - Alleles
MH  - Atorvastatin/*adverse effects/therapeutic use
MH  - Female
MH  - HLA Antigens/*analysis
MH  - Humans
MH  - Stevens-Johnson Syndrome/*drug therapy/physiopathology
PMC - PMC7837978
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2021/02/07 06:00
MHDA- 2021/02/16 06:00
PMCR- 2021/01/22
CRDT- 2021/02/06 01:02
PHST- 2020/10/16 00:00 [received]
PHST- 2020/12/29 00:00 [accepted]
PHST- 2021/02/06 01:02 [entrez]
PHST- 2021/02/07 06:00 [pubmed]
PHST- 2021/02/16 06:00 [medline]
PHST- 2021/01/22 00:00 [pmc-release]
AID - 00005792-202101220-00161 [pii]
AID - MD-D-20-10095 [pii]
AID - 10.1097/MD.0000000000024392 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2021 Jan 22;100(3):e24392. doi: 
      10.1097/MD.0000000000024392.