Favorable outcome of managing a pregnant woman with epidermolytic drug syndrome
Background. Epidermolytic drug reactions (EDR) in pregnant women have been described in single cases. The mortality rates for Stevens-Johnson syndrome and Lyell syndrome are 5.0–7.5% and 30–70%, respectively. The proven association of the syndromes with drugs, viral diseases necessitates systematization of practical knowledge, which is relevant for the management of pregnant women and the elaboration of obstetric tactics.Tezikov Yu.V., Tezikova T.A., Lipatov I.S., Shmakov R.G., Rakitina V.N., Mishina E.A.
Case report. The clinical case of a pregnant woman with EDR demonstrates difficulties in the differential diagnosis of Stevens-Johnson syndrome with transformation into Lyell syndrome with hemorrhagic vasculitis, toxicoderma, psoriasis, and a favorable gestational outcome during medical treatment for a large lesion area. The management of pregnant near miss cases required an interdisciplinary approach. The capabilities of telemedicine are used to make consultations by specialists.
Conclusion. The accumulation of clinical experience and the choice of medical policy with a high level of evidence will undoubtedly allow avoiding maternal and perinatal critical conditions in the medical management of pregnant women with EDR.
Keywords
pregnancy
epidermolytic drug reactions
Stevens-Johnson syndrome
Lyell syndrome
gestational outcome
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Received 26.10.2020
Accepted 05.02.2021
About the Authors
Yurii V. Tezikov, MD, professor, Head of the Department of Obstetrics and Gynecology No.1, Samara State Medical University, Ministry of Health of Russia.E-mail: yra.75@inbox.ru. ORCID: 0000-0002-8946-501X. 443099, Russia, Samara, Chapaevskaya str., 89.
Tatiana A. Tezikova, Deputy Chief Physician for Obstetrics and Gynecology, Perinatal Center of Samara Regional Clinical Hospital named after V.D. Seredavin.
E-mail: t-tezikova@mail.ru. ORCID: 0000-0001-9747-9588. 443095, Russia, Samara, Tashkentskaya str., 159.
Igor S. Lipatov, MD, professor, professor of the Department of Obstetrics and Gynecology No. 1, Samara State Medical University, Ministry of Health of Russia.
E-mail: i.lipatoff2012@yandex.ru. ORCID: 0000-0001-7277-7431. 443099, Russia, Samara, Chapaevskaya str., 89.
Roman G. Shmakov, MD, Professor of the RAS, Director of the Institute of Obstetrics, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia.
E-mail: mdshmakov@mail.ru. ORCID: 0000-0002-2206-1002. 117997, Russia, Moscow, Ac. Oparina str., 4.
Valentina N. Rakitina, Head of Obstetric Department, Perinatal Center of Samara Regional Clinical Hospital named after V.D. Seredavin. E-mail: t-tezikova@mail.ru.
443095, Russia, Samara, Tashkentskaya str., 159.
Elena A. Mishina, Head of Anesthesiology and Intensive Care Department, Perinatal Center of Samara Regional Clinical Hospital named after V.D. Seredavin.
E-mail:t-tezikova@mail.ru. 443095, Russia, Samara, Tashkentskaya str., 159.
For citation: Tezikov Yu.V., Tezikova T.A., Lipatov I.S., Shmakov R.G., Rakitina V.N., Mishina E.A. Favorable outcome of managing a pregnant woman with epidermolytic drug syndrome.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 4: 158-164 (in Russian)
https://dx.doi.org/10.18565/aig.2021.4.158-164
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