title: Stevens-Johnson syndrome caused by a health drink (Eberu) containing ophiopogonis tuber.
abstract: Stevens-Johnson syndrome is considered to be a severe type of erythema exsudativum multiforme. It is characterized by erythema with bullous and eroded lesions of skin and mucous membranes. We report a case of Steven-Johnson syndrome following consumption of a health drink containing ophiopogonis tuber. A 66-year-old female took an O.T.C. health drink for fever. The next morning, she noted erythema and swelling of her face, neck, and chest. She started to develop bullous and eroded lesions on the skin of her entire body and the mucous membranes of her oral cavity, conjunctiva, and cornea, and she became feverish. She had high degrees of corneal erosion and liver dysfunction. Skin biopsy showed diffuse necrosis of the epidermis. After admission to the hospital, steroid pulse therapy (1000 mg/day of methylprednisolone sodium succinate) was continued for 5 days. The health drink induced a positive drug lymphocyte stimulation test (DLST) and patch test. A challenge test was done with a one hundredth dose, and it was positive. We did patch tests with all components of the drink and found that Mai-Meu-Dong-Tang (ophiopogonis) alone was positive at 72 hours. There is no previous report of Stevens-Johnson syndrome caused by a health drink or Mai-Meu-Dong-Tang. Even though it is a health drink, we should be aware of the possibility of a severe reaction.
authors.affiliation: Department of Dermatology, Kagoshima University Faculty of Medicine, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Mochitomi
authors.forename: A
authors.initials: A
authors.lastname: Inoue
authors.forename: H
authors.initials: H
authors.lastname: Kawabata
authors.forename: S
authors.initials: S
authors.lastname: Ishida
authors.forename: T
authors.initials: T
authors.lastname: Kanzaki
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001628:Beverages / Q000009:adverse effects; D003875:Drug Eruptions / Q000209:etiology*; D004365:Drugs, Chinese Herbal / Q000009:adverse effects*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008776:Methylprednisolone Hemisuccinate / Q000008:administration & dosage / Q000627:therapeutic use; D010946:Plants, Medicinal / Q000009:adverse effects*; D013262:Stevens-Johnson Syndrome / Q000139:chemically induced*
chemical_list: D000893:Anti-Inflammatory Agents; D004365:Drugs, Chinese Herbal; D005938:Glucocorticoids; D008776:Methylprednisolone Hemisuccinate