[Drug-induced erythrodermia complicated by multiorgan failure--case report].
Generalized erythroderma or exfoliative dermatitis, is a disease characterized by the appearance of erythematous and scaling skin changes, which often cover greater than 90% of the body's surface. The resulting failure of the skin can coexist with other organ failure and is potentially life threatening. We present a case of a young woman admitted with symptoms of erythrodermia complicated lung and liver failure. The patient's medical history in the first row pointed to the possibility of the coexistence of flu-like infection and drug-induced reactions by antibiotic (makrolide) and nonsteroidal anti-inflammatory drugs (acetaminophen, ibuprofen) therapy two weeks before hospitalization. Rapid progress of the disease and the degree of liver damage found to meet the criteria for liver transplantation for acute liver failure. However, the coexistence of pneumonia and transfusion-related acute lung injury (TRALI) were the reason to postpone transplantation until healing inflammation process and improving lung function. Standard medical therapy was extended by liver albumin dialysis (MARS) with gradual improvement of general state and complete resolution of symptoms. Differential diagnosis was performed and coexistence of other systemic and neoplastic diseases was excluded.
Klinika Toksykologii i Chorób Srodowiskowych, Uniwersytet Jagielloński, Collegium Medicum w Krakowie. piodzik@poczta.onet.pl
Piotr
P
Hydzik
Tomasz
T
Gawlikowski
Barbara
B
Groszek
D000082:Acetaminophen / Q000009:adverse effects*; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D017291:Clarithromycin / Q000009:adverse effects*; D003873:Dermatitis, Exfoliative / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects*; D017114:Liver Failure, Acute / Q000139:chemically induced*; D009102:Multiple Organ Failure / Q000139:chemically induced*; D011014:Pneumonia / Q000150:complications / Q000188:drug therapy
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen; D017291:Clarithromycin; D007052:Ibuprofen