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Sofosbuvir induced steven Johnson Syndrome in a patient with hepatitis C virus‐related cirrhosis

Sofosbuvir is an imperative drug used in treatment regimens for hepatitis C virus (HCV). It is considered relatively safe with fewer adverse effects than other treatments. Here, we report a rare and potentially serious, dermatologic, adverse effect following the use of sofosbuvir. A 35‐year‐old man...

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Autores principales: Verma, Nipun, Singh, Shreya, Sawatkar, Gitesh, Singh, Virendra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5776873/
https://www.ncbi.nlm.nih.gov/pubmed/29404508
http://dx.doi.org/10.1002/hep4.1126
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author Verma, Nipun
Singh, Shreya
Sawatkar, Gitesh
Singh, Virendra
author_facet Verma, Nipun
Singh, Shreya
Sawatkar, Gitesh
Singh, Virendra
author_sort Verma, Nipun
collection PubMed
description Sofosbuvir is an imperative drug used in treatment regimens for hepatitis C virus (HCV). It is considered relatively safe with fewer adverse effects than other treatments. Here, we report a rare and potentially serious, dermatologic, adverse effect following the use of sofosbuvir. A 35‐year‐old man with genotype 3‐related HCV cirrhosis presented with decompensated ascites and jaundice following 7 weeks of therapy with peginterferon alpha‐2a and oral ribavirin. After peginterferon withdrawal and stabilization, oral sofosbuvir and ribavirin were started; 10 days later, he developed itching over the trunk and legs, followed by multiple papules and vesicles over an erythematous base. Over the next 15 days, the rash progressed with the formation of blisters and peeling skin. Simultaneously, the oral mucosa and lips developed crusting and painful erosions. Considering drug‐induced Steven John Syndrome (SJS), sofosbuvir and ribavirin were withdrawn and the patient was treated with topical emollients, steroids, and supportive care. The lesions improved over the next 4 weeks, with some residual hyperpigmentation. Rechallenge with sofosbuvir alone at one eighth the dose resulted in similar skin and mucosal lesions after 2 months; these lesions also improved after sofosbuvir withdrawal. The Algorithm of Drug Causality for Epidermal Necrolysis score was 7, which suggested sofosbuvir as the very probable drug resulting in SJS in our patient. Conclusion: The appearance of SJS following sofosbuvir use is an important and potentially fatal complication from a drug that serves as the backbone of several HCV treatment regimens. Treating physicians must use sofosbuvir with caution and consider withholding or discontinuing this drug in patients with such severe dermatologic manifestations. (Hepatology Communications 2018;2:16–20)
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spelling pubmed-57768732018-02-05 Sofosbuvir induced steven Johnson Syndrome in a patient with hepatitis C virus‐related cirrhosis Verma, Nipun Singh, Shreya Sawatkar, Gitesh Singh, Virendra Hepatol Commun Brief Reports Sofosbuvir is an imperative drug used in treatment regimens for hepatitis C virus (HCV). It is considered relatively safe with fewer adverse effects than other treatments. Here, we report a rare and potentially serious, dermatologic, adverse effect following the use of sofosbuvir. A 35‐year‐old man with genotype 3‐related HCV cirrhosis presented with decompensated ascites and jaundice following 7 weeks of therapy with peginterferon alpha‐2a and oral ribavirin. After peginterferon withdrawal and stabilization, oral sofosbuvir and ribavirin were started; 10 days later, he developed itching over the trunk and legs, followed by multiple papules and vesicles over an erythematous base. Over the next 15 days, the rash progressed with the formation of blisters and peeling skin. Simultaneously, the oral mucosa and lips developed crusting and painful erosions. Considering drug‐induced Steven John Syndrome (SJS), sofosbuvir and ribavirin were withdrawn and the patient was treated with topical emollients, steroids, and supportive care. The lesions improved over the next 4 weeks, with some residual hyperpigmentation. Rechallenge with sofosbuvir alone at one eighth the dose resulted in similar skin and mucosal lesions after 2 months; these lesions also improved after sofosbuvir withdrawal. The Algorithm of Drug Causality for Epidermal Necrolysis score was 7, which suggested sofosbuvir as the very probable drug resulting in SJS in our patient. Conclusion: The appearance of SJS following sofosbuvir use is an important and potentially fatal complication from a drug that serves as the backbone of several HCV treatment regimens. Treating physicians must use sofosbuvir with caution and consider withholding or discontinuing this drug in patients with such severe dermatologic manifestations. (Hepatology Communications 2018;2:16–20) John Wiley and Sons Inc. 2017-11-11 /pmc/articles/PMC5776873/ /pubmed/29404508 http://dx.doi.org/10.1002/hep4.1126 Text en © 2017 The Authors. Hepatology Communications published by Wiley Periodicals, Inc., on behalf of the American Association for the Study of Liver Diseases. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Brief Reports
Verma, Nipun
Singh, Shreya
Sawatkar, Gitesh
Singh, Virendra
Sofosbuvir induced steven Johnson Syndrome in a patient with hepatitis C virus‐related cirrhosis
title Sofosbuvir induced steven Johnson Syndrome in a patient with hepatitis C virus‐related cirrhosis
title_full Sofosbuvir induced steven Johnson Syndrome in a patient with hepatitis C virus‐related cirrhosis
title_fullStr Sofosbuvir induced steven Johnson Syndrome in a patient with hepatitis C virus‐related cirrhosis
title_full_unstemmed Sofosbuvir induced steven Johnson Syndrome in a patient with hepatitis C virus‐related cirrhosis
title_short Sofosbuvir induced steven Johnson Syndrome in a patient with hepatitis C virus‐related cirrhosis
title_sort sofosbuvir induced steven johnson syndrome in a patient with hepatitis c virus‐related cirrhosis
topic Brief Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5776873/
https://www.ncbi.nlm.nih.gov/pubmed/29404508
http://dx.doi.org/10.1002/hep4.1126
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