Abstract
BackgroundStevens-Johnson syndrome (SJS) is a severe skin and mucosal bullous disease. When complicated with Hemophagocytic lymphohistiocytosis (HLH), the condition is especially life-threatening.Case presentationHere we report the case of a 4-year-old boy suffering from SJS with extensive erythema multiforme and bulla. Despite active intervention and supportive care, the boy experienced increased skin lesions and a higher fever. Meanwhile, decreases in white blood cell count and hemoglobin were observed. Hyperferritinemia, increased soluble CD25 level, decreased NK cell activity and hemophagocytosis in the boy’s bone marrow confirmed the diagnosis of HLH. After high-dose intravenous immunoglobulin and methylprednisone pulse therapy, the boy was discharged in good condition.ConclusionSimultaneous occurrence of HLH and SJS is very uncommon and the condition is life-threatening. Pancytopenia can be a precocious indicator and enables to start a prompt diagnosis and treatment.
Highlights
Stevens-Johnson syndrome (SJS) is a severe skin and mucosal bullous disease
Hemophagocytic lymphohistiocytosis (HLH) has seldom been reported in patients with SJS
It should be noted that both SJS and HLH have a high mortality rate, so concurrence of the two in a patient is especially danger
Summary
Simultaneous occurrence of HLH and SJS is very uncommon and the condition is life-threatening.
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