Stevens-Johnson syndrome risk factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anila Hussain, MD [2]

Common risk factors in the development of SJS include immunodeficiency, HIV infection, active malignancy (particularly Hematological cancers), genetic Predisposition ( HLA-B 1502 and HLA-B 5801 variants in particular) on exposure to antiepileptic medications or Allopurinol. Other risk factors may include past or family history of SJS/TEN, radiation therapy and rapid use of medications.

Common risk factors in the development of Stevens-Johnson Syndrome include the following:

• Risk of Developing SJS is 100 times greater in HIV Infected people as compared to the general population^[1]

• Immunodeffeciency also increases the risk of developing SJS/TEN. Conditions may include Autoimmune diseases like SLE, Organ Transplant and HIV/AIDS^[2]

• Certain Malignancies increase the risk of SJS particularly Lymphomas and other Hematological cancers^[3]

• Some people have genetic predisposition which increases their risk of developing SJS in response to certain trigger medications. The most common genetic variation contributing to the predisposition is seen in the HLA-B gene. Examples include
  • People with HLA-B 1502 gene have 10 percent risk of developing SJS on exposure to anti-epileptic drugs like Phenytoin, Carbamazepine, Phenobarbital, Lamotrigine^[4]
  • People with HLA-B 5801 have high risk of developing SJS on exposure to Allupurinol^[5]
  • Certain studies have identified HLA-B 3101 as a genetic risk factor for Carbamazepine induced skin reactions including SJS^[6]
  • HLA-B 1511, HLA-B 2402 are also considered to increase SJS risk in certain populations
• Genetic polymorphism in CYP2C gene variants may lead to an increased risk of SJS/TEN on exposure to certain anti-seizure medications in some populations^[7]

Other factors that may increase the risk of SJS inclde;

• Past history of SJS
• Family history of SJS
• High dose of medications
• Rapid Intake of medications
• Physical stimuli like radiation therapy^[8]

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