Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Gastroenterology (Expert Forum)
Possible side affects from Stevens-Johnson Syndrome?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Possible side affects from Stevens-Johnson Syndrome?
by amydavis2000, Nov 27, 2003 12:00AM
I was hospitalized 6/2003 for 5 days with Stevens-Johnson Syndrome after taking 3 Z-packs for bronchitus (bronchitis) that developed in to pneumonia. I was treated with very heavy doses of Decadron and released from the hospital with a 12 week taper of steroids. I had minimal eye involvement (dry eye) and luckily my rash (painfully, I might add) peeled like a sunburn. I call myself lucky that my symptoms were subsided by steroids.
Since my stay at the hospital, I have been fighting with bad bouts of diarrhea and abdominal pain. The pain started just under the middle of my ribcage and has progressed to my right side, causing bad back pain, in my right armpit, under my right ribs, and at times shoots down to my lower right back. My entire right side is tender to the touch and at times, so is my lower mid-abdomen.
History:
I have hypothyroidism - taking 225 mcg of Levoxyl and my TSH is perfect as of 7/2003
I am obese - about 100 pounds overweight but losing weight rapidly due to a severe decrease in appetite (7 pounds last week) and bouts of nausea - not to mention on a slow weightloss diet
I feel sick all of the time (my neck lymph nodes are often swollen and my throat hurts).
I am fatigued...I wake up with energy and crash by 1pm...this is not typical for me - for an obese person I am very active.
I am taking acidipholous because stool samples showed no good bacteria.
My GI put me on an anti-infective (begins with a M??) because he feels I still have an infection.
I am taking Robinol Forte - 2 x's day for pain which usually helps but as pain gets worse it is not working as well.
In the past month I have had done:
Abdominal ultrasound - found fatty liver
Abdomen and pelvic CT with and without barium - found moderate fatty infiltration of the liver
SGOT = 45; SGPT = 62
Surprise of the day - I am anemic (have never been before): MCH = 25.7 and MCV = 75
Side note: Liver ultrasound less than 2 years ago during pre-eclampsia pregancy showed no fatty liver and I have been obese for 7 years
My GI doc sent me for hepatitus (hepatitis) testing, but had that in hospital (B & C) 6/2003 and both were negative.
Questions:
1. Is IT AT ALL POSSIBLE that my Stevens-Johnson Syndrome, reaction to Zithromax (this is the only culprit we could figure caused it) caused damage to my liver?
2. If this isn't hepatitus (hepatitis), what are the other possibilities? I can't live with this pain...it is unbearable at times.
3. What causes someone to become anemic when they are eating an iron-rich diet already (seeing a nutritionalist)?
4. Could my diarrhea, nausea when eating/when I lay down, side pain, fatigue, constant chapped lips, mouth ulcers, stomach burning in the morning, and general ill-feeling be related? Are these common post-SJS reaction symptoms?
None of my physicians have dealt with SJS patients first-hand so I am not sure that it is being considered as a probability. Please help!
Since my stay at the hospital, I have been fighting with bad bouts of diarrhea and abdominal pain. The pain started just under the middle of my ribcage and has progressed to my right side, causing bad back pain, in my right armpit, under my right ribs, and at times shoots down to my lower right back. My entire right side is tender to the touch and at times, so is my lower mid-abdomen.
History:
I have hypothyroidism - taking 225 mcg of Levoxyl and my TSH is perfect as of 7/2003
I am obese - about 100 pounds overweight but losing weight rapidly due to a severe decrease in appetite (7 pounds last week) and bouts of nausea - not to mention on a slow weightloss diet
I feel sick all of the time (my neck lymph nodes are often swollen and my throat hurts).
I am fatigued...I wake up with energy and crash by 1pm...this is not typical for me - for an obese person I am very active.
I am taking acidipholous because stool samples showed no good bacteria.
My GI put me on an anti-infective (begins with a M??) because he feels I still have an infection.
I am taking Robinol Forte - 2 x's day for pain which usually helps but as pain gets worse it is not working as well.
In the past month I have had done:
Abdominal ultrasound - found fatty liver
Abdomen and pelvic CT with and without barium - found moderate fatty infiltration of the liver
SGOT = 45; SGPT = 62
Surprise of the day - I am anemic (have never been before): MCH = 25.7 and MCV = 75
Side note: Liver ultrasound less than 2 years ago during pre-eclampsia pregancy showed no fatty liver and I have been obese for 7 years
My GI doc sent me for hepatitus (hepatitis) testing, but had that in hospital (B & C) 6/2003 and both were negative.
Questions:
1. Is IT AT ALL POSSIBLE that my Stevens-Johnson Syndrome, reaction to Zithromax (this is the only culprit we could figure caused it) caused damage to my liver?
2. If this isn't hepatitus (hepatitis), what are the other possibilities? I can't live with this pain...it is unbearable at times.
3. What causes someone to become anemic when they are eating an iron-rich diet already (seeing a nutritionalist)?
4. Could my diarrhea, nausea when eating/when I lay down, side pain, fatigue, constant chapped lips, mouth ulcers, stomach burning in the morning, and general ill-feeling be related? Are these common post-SJS reaction symptoms?
None of my physicians have dealt with SJS patients first-hand so I am not sure that it is being considered as a probability. Please help!
Doctor's Answer
by Kevin Pho, MD, Nov 28, 2003 12:00AM
, Nov 28, 2003 12:00AM
To answer your questions:
1) I am unaware of the Stevens-Johnson syndrome (SJS) being associated with liver damage.
2) Possible causes can include dyspepsia (i.e. GERD, inflammation of the stomach and esophagus, or an ulcer), inflammation of the colon, or abdominal mass. I would suggest discussing whether an upper and/or lower endoscopy would help in evaluating your symptoms.
3) There are many other reasons other than iron deficiency that can cause anemia. They can include hereditary disorders (thalassemia), occult GI blood loss, B12 or folate deficiency or any type of chronic disease (i.e. kidney or liver disease).
4) Your GI symptoms can certainly be all related. I am unaware of SJS causing GI symptoms directly, but it can certainly be possible.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
1) I am unaware of the Stevens-Johnson syndrome (SJS) being associated with liver damage.
2) Possible causes can include dyspepsia (i.e. GERD, inflammation of the stomach and esophagus, or an ulcer), inflammation of the colon, or abdominal mass. I would suggest discussing whether an upper and/or lower endoscopy would help in evaluating your symptoms.
3) There are many other reasons other than iron deficiency that can cause anemia. They can include hereditary disorders (thalassemia), occult GI blood loss, B12 or folate deficiency or any type of chronic disease (i.e. kidney or liver disease).
4) Your GI symptoms can certainly be all related. I am unaware of SJS causing GI symptoms directly, but it can certainly be possible.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
