title: SJS/TEN overlap associated with lomefloxacin: case report and molecular typing studies.
abstract: BACKGROUND
  Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) may develop in susceptible patients after administration of different drugs. Only mild cutaneous reactions have been related to lomefloxacin. A correlation between human leucocyte antigen (HLA) and cutaneous adverse reaction has been identified.
  
  
  METHODS
  Twenty-four hours after intake of lomefloxacin, a 30-year-old Caucasian woman developed a severe skin reaction with symptoms suggesting SJS/TEN. The fast onset reaction worsened with skin blisters and 20% body surface area skin detachment within 48 h. Burn unit admittance was required; corticosteroids and human immunoglobulins were administered. Complete recovery occurred within 3 months, except for epidermal discoloration. Molecular studies showed a peculiar profile characterized by HLA class I genotype rich of ligands for natural killer cell immunoglobulin-like receptors (KIR) and HLA class II haplotype, HLA-DRB1*03:01,DQB1*02:01, prone to autoimmunity.
  
  
  CONCLUSIONS
  While the HLA profile approaches our case to other well-documented drug-induced SJS/TEN, KIR involvement still remains puzzling.
authors.affiliation: Pavia Poison Control Centre and National Toxicology Information Centre, IRCCS Maugeri Foundation Clinical Institute and University of Pavia, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Lonati
authors.forename: Arturo
authors.initials: A
authors.lastname: Zancan
authors.forename: Annamaria
authors.initials: A
authors.lastname: Pasi
authors.forename: Annia
authors.initials: A
authors.lastname: Schreiber
authors.forename: Andrea
authors.initials: A
authors.lastname: Giampreti
authors.forename: Patrizia
authors.initials: P
authors.lastname: Pignatti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Stella
authors.forename: Carlo Alessandro
authors.initials: CA
authors.lastname: Locatelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Manzo
authors.forename: Miryam
authors.initials: M
authors.lastname: Martinetti
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D005260:Female; D024841:Fluoroquinolones / Q000009:adverse effects*; D005805:Genes, MHC Class I; D005802:Genes, MHC Class II; D005838:Genotype; D059951:HLA-G Antigens / Q000235:genetics; D006801:Humans; D058889:Molecular Typing; D011110:Polymorphism, Genetic; D054340:Receptors, KIR / Q000235:genetics; D013262:Stevens-Johnson Syndrome / Q000209:etiology / Q000235:genetics* / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D059951:HLA-G Antigens; D054340:Receptors, KIR; C053091:lomefloxacin