Warfarin-induced toxic epidermal necrolysis after mitral valve replacement

Asian Cardiovasc Thorac Ann. 2020 Nov;28(9):601-603. doi: 10.1177/0218492320951024. Epub 2020 Aug 12.

Abstract

Stevens-Johnson syndrome and toxic epidermal necrolysis are rare diseases that cause acute destruction of the epithelium of the skin and mucous membranes, almost always attributable to drugs. However, warfarin-induced Stevens-Johnson syndrome and toxic epidermal necrolysis is extremely rare. We report the case of 71-year-old woman who died due to destructive erosion all over her skin and mucous membranes. She had received a mitral valve prosthesis, and warfarin was prescribed for antithrombotic therapy. A lymphocyte transformation test for drug hypersensitivity and the clinical history confirmed this phenomenon as warfarin-induced toxic epidermal necrolysis.

Keywords: Drug hypersensitivity; eosinophilia; heart valve prosthesis implantation; necrosis; stevens-johnson syndrome; warfarin.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anticoagulants / adverse effects*
  • Fatal Outcome
  • Female
  • Heart Valve Prosthesis Implantation*
  • Humans
  • Mitral Valve / surgery*
  • Mitral Valve Insufficiency / surgery*
  • Stevens-Johnson Syndrome / diagnosis
  • Stevens-Johnson Syndrome / etiology*
  • Warfarin / adverse effects*

Substances

  • Anticoagulants
  • Warfarin