Therapeutic Causes of Stevens - Johnson Syndrome - A Mini Review

Abstract

Stevens-Johnson syndrome, a form of life-threatening, toxic epidermal necrolysis in which epidermis is separated from the dermis. Aromatic drugs with heteroatoms such as sulphur, nitrogen and oxygen can cause Stevens-Johnson Syndrome. Examples of such drugs are berbiturates, oxicam derivatives, sulphonamides, etc. Mouth, eyes, skin and urogenital parts are affected. The treatment includes the use of analgesics, steroids, eye ointment among others. The SJS/TEN could be genetic via granulysin and via immunogenic activity involving white blood cells, cytokines or by formation of antigen antibody complex. Adults and young humans can be affected. Consumption of meats that contain traces of some drugs could also cause SJS/TEN. Also drugs or compounds that are tautomeric may cause Stevens Johnson Syndrome and Parkinsonism.

Unique Pharmacokinetic and Pharmacodynamic Parameters of Antimicrobials in Goats

“…This may be due to the presence of desamino-sulfonamide, a sulfadimidine metabolite [75] which is eliminated slowly, thereby increasing the withdrawal time [76]. Lack of adequate water to dilute crystals of sulfadimidine in the kidney can lead to crystalluria that can consequently cause nephrosis in the affected animals [44], and consumptions of meats with high residues of sulfadimidine can cause Steven-Johnson syndrome in sensitive humans who may be slow or fast acetylators [13,23]. Based on the tissue tolerance limit in cattle (5 ppm), the withdrawal period for tulathromycin is 19 days in cattle and 34 days in goat when administered subcutaneously [5].…”

“…However, Capra aegagrus hircus is the most popular domesticated from their wild progenitor, bezoar (Capra aegagrus) [21,22]. Also, antimicrobials such as sulfonamides, trimethoprimsulfamethoxazole, aminopenicillins, cephalosporins and quinolones could cause Stevens-Johnson syndrome in humans that eat goat meat which has the drugs residues [23] and tissue residues above threshold (2 ppm) could be found in the skeletal muscle, liver, kidney, milk, brain, intestine, heart and lung of goats which could portend threat to public health [13]. Although goats are domesticated 10,500 years ago, the genomic regions differentiating domestic goats from wild goats are associated to genes of the nervous system, immunity and productivity traits; 20 are common to Capra and Ovis [24] indicating the possible relevance of pharmacogenomics which is the study of how genes affect animal response to drugs.…”