title: Erythematous and bullous rash strongly indicating toxic epidermal necrolysis associated with the use of intravenous ritodrine hydrochloride.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Tokyo, Japan. ua8m-sb@asahi-net.or.jp
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shiba
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kido
authors.forename: Koichi
authors.initials: K
authors.lastname: Umezawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Higaki
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Akinori
authors.initials: A
authors.lastname: Taguchi
authors.forename: Takashi
authors.initials: T
authors.lastname: Hayashi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Higaki
authors.forename: Yukifumi
authors.initials: Y
authors.lastname: Sasamori
authors.forename: Norio
authors.initials: N
authors.lastname: Shinozuka
authors.forename: Yoji
authors.initials: Y
authors.lastname: Fuse
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kikuchi
authors.forename: Takuya
authors.initials: T
authors.lastname: Ayabe
mesh_terms: 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
chemical_list: D000318:Adrenergic beta-Agonists; D005938:Glucocorticoids; D011239:Prednisolone; D012312:Ritodrine