title: Sodium nitroprusside and toxic epidermal necrolysis.
abstract: Sodium nitroprusside (SNP) is one of the most widely used parenteral antihypertensive agents in severe hypertension management. Toxic epidermal necrolysis (TEN) is a rare, mostly drug-induced, severe muco-cutoneous reaction with various complications and high mortality. A fifteen years old girl who is on hemodialysis for chronic renal insufficiency and was hospitalized for emergency management of hypertension, developed a diffuse maculopapular rash within minutes after SNP infusion. In 72 hours, approximately 40% of the body surface was involved with skin detachment indicating epidermal necrolysis and a skin biopsy confirmed the diagnosis of TEN. To the best of our knowledge there is no report of an association of SNP and TEN in the English literature and the clinical data exemplifying consequent IgE and non-IgE mediated hypersensitivity reactions are scanty. With this report we wanted to present a rare complication of SNP infusion indicating another rare occurrence of sequential IgE and non-IgE mediated hypersensitivity reactions.
authors.affiliation: Department of Pediatric Allergy and Clinical Immunology, Ondokuz Mayis University, Faculty of Medicine, Samsun, Turkey.
authors.forename: Mehtap
authors.initials: M
authors.lastname: Kilic
authors.forename: Fadil
authors.initials: F
authors.lastname: Ozturk
authors.forename: Gurkan
authors.initials: G
authors.lastname: Genc
authors.forename: Sukru Nail
authors.initials: SN
authors.lastname: Guner
authors.forename: Levent
authors.initials: L
authors.lastname: Yildiz
authors.forename: Recep
authors.initials: R
authors.lastname: Sancak
mesh_terms: D000293:Adolescent; D000959:Antihypertensive Agents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009599:Nitroprusside / Q000009:adverse effects*; D013262:Stevens-Johnson Syndrome / Q000209:etiology*
chemical_list: D000959:Antihypertensive Agents; D009599:Nitroprusside