Erythematous and bullous rash strongly indicating toxic epidermal necrolysis associated with the use of intravenous ritodrine hydrochloride.
Toxic epidermal necrolysis (TEN) is a very rare drug reaction associated with a high mortality rate. This condition warrants prompt recognition, diagnosis and treatment. Only one case report of TEN that was possibly induced by ritodrine hydrochloride, a tocolytic agent, was found in English literature. Here, we report the case of a 26-year-old pregnant woman who was suspected with TEN following the intravenous administration of ritodrine hydrochloride in the 35(th) week of gestation. An emergency cesarean section was performed because the labor pains caused systemic intolerable haphalgesia. After the surgery, intensive dermatological treatment commenced, which helped her recover from the serious condition. The result of the drug-induced lymphocyte stimulation test for ritodrine hydrochloride was positive. When a skin eruption appears during the administration of ritodrine, we must consider the benefits as well as the risks of continuous use of tocolytic agents because there is a risk of Stevens-Johnson syndrome or TEN.
Shiba
Masahiro
M
Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Tokyo, Japan. ua8m-sb@asahi-net.or.jp
Kido
Koichiro
K
Umezawa
Koichi
K
Higaki
Hiroshi
H
Matsumoto
Sachiyo
S
Taguchi
Akinori
A
Hayashi
Takashi
T
Higaki
Yuko
Y
Sasamori
Yukifumi
Y
Shinozuka
Norio
N
Fuse
Yoji
Y
Kikuchi
Akihiko
A
Ayabe
Takuya
T
D000318:Adrenergic beta-Agonists / Q000009:adverse effects; D000328:Adult; D001768:Blister / Q000209:etiology*; D002585:Cesarean Section; D004890:Erythema / Q000209:etiology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use; D011247:Pregnancy; D012312:Ritodrine / Q000009:adverse effects*; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome
D000318:Adrenergic beta-Agonists; D005938:Glucocorticoids; D011239:Prednisolone; D012312:Ritodrine