Stevens-Johnson syndrome laboratory findings: Difference between revisions
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==Overview== | ==Overview== | ||
SJS is mainly diagnosed through the clinical skin findings. However skin biospy is helpful in making the definitive diagnosis. Other tests are done to either rule out the superimposed bacterial infection, measure disease severity or detect the causative agent or organism. Tests include CBC, BMP, Blood cultures, ESR, CRP, IL-6, ELISA for virus detection among others. | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
Skin Biopsy is the only study that can make the definitive diagnosis of SJS. Other Lab tests are done to detect superimposed bacterial infection or in cases of severe or extensive skin involvement that is more commonly seen in TEN as compared to SJS. | |||
First Step after suspicion of SJS is identifying and discontinuing the offending agent. | |||
Following tests are done<ref name="pmid20118388">{{cite journal| author=Wetter DA, Camilleri MJ| title=Clinical, etiologic, and histopathologic features of Stevens-Johnson syndrome during an 8-year period at Mayo Clinic. | journal=Mayo Clin Proc | year= 2010 | volume= 85 | issue= 2 | pages= 131-8 | pmid=20118388 | doi=10.4065/mcp.2009.0379 | pmc=2813820 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20118388 }}</ref>: | |||
* Skin Biopsy: Lesional Biopsy and Perilesional Biopsy-To confirm the diagnosis of SJS and rule out other autoimmune skin conditions ( for example Pemphigus Vulgaris, Bullous pemphigoid, GVHD, SSSS, Linear IgA bullous dermatosis) | |||
* Complete Blood Count: Abnormal blood counts can be seen in case of superimposed bacterial infections | |||
* Metabolic Panel: Electrolyte disturbances, Glucose, BUN, Cr, Total protein, ALT, AST- Abnormalities seen in cases of extensive disease with Dehydration, Bacteremia, Hypovolumic shock and Multiorgan failure<ref name="pmid27738400">{{cite journal| author=Çekiç Ş, Canıtez Y, Sapan N| title=Evaluation of the patients diagnosed with Stevens Johnson syndrome and toxic epidermal necrolysis: a single center experience. | journal=Turk Pediatri Ars | year= 2016 | volume= 51 | issue= 3 | pages= 152-158 | pmid=27738400 | doi=10.5152/TurkPediatriArs.2016.3836 | pmc=5047364 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27738400 }}</ref> | |||
* Bacterial and Fungal Cultures- Taken from Blood, Mucosal surfaces | |||
* CRP, ESR, TNF-alpha, IL-6: Levels are typically elevated | |||
* Bronchoscopy, EGD: may be needed to detect mucosal lesions | |||
* HSV-IgM | |||
* Mycoplasma IgM | |||
* ELISA-to detect other causative viruses (HAV, HBV, HCV, HIV, EBV, Rubella, | |||
==References== | ==References== | ||
Revision as of 15:27, 29 August 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
SJS is mainly diagnosed through the clinical skin findings. However skin biospy is helpful in making the definitive diagnosis. Other tests are done to either rule out the superimposed bacterial infection, measure disease severity or detect the causative agent or organism. Tests include CBC, BMP, Blood cultures, ESR, CRP, IL-6, ELISA for virus detection among others.
Laboratory Findings
Skin Biopsy is the only study that can make the definitive diagnosis of SJS. Other Lab tests are done to detect superimposed bacterial infection or in cases of severe or extensive skin involvement that is more commonly seen in TEN as compared to SJS.
First Step after suspicion of SJS is identifying and discontinuing the offending agent.
Following tests are done[1]:
- Skin Biopsy: Lesional Biopsy and Perilesional Biopsy-To confirm the diagnosis of SJS and rule out other autoimmune skin conditions ( for example Pemphigus Vulgaris, Bullous pemphigoid, GVHD, SSSS, Linear IgA bullous dermatosis)
- Complete Blood Count: Abnormal blood counts can be seen in case of superimposed bacterial infections
- Metabolic Panel: Electrolyte disturbances, Glucose, BUN, Cr, Total protein, ALT, AST- Abnormalities seen in cases of extensive disease with Dehydration, Bacteremia, Hypovolumic shock and Multiorgan failure[2]
- Bacterial and Fungal Cultures- Taken from Blood, Mucosal surfaces
- CRP, ESR, TNF-alpha, IL-6: Levels are typically elevated
- Bronchoscopy, EGD: may be needed to detect mucosal lesions
- HSV-IgM
- Mycoplasma IgM
- ELISA-to detect other causative viruses (HAV, HBV, HCV, HIV, EBV, Rubella,
References
- ↑ Wetter DA, Camilleri MJ (2010). "Clinical, etiologic, and histopathologic features of Stevens-Johnson syndrome during an 8-year period at Mayo Clinic". Mayo Clin Proc. 85 (2): 131–8. doi:10.4065/mcp.2009.0379. PMC 2813820. PMID 20118388.
- ↑ Çekiç Ş, Canıtez Y, Sapan N (2016). "Evaluation of the patients diagnosed with Stevens Johnson syndrome and toxic epidermal necrolysis: a single center experience". Turk Pediatri Ars. 51 (3): 152–158. doi:10.5152/TurkPediatriArs.2016.3836. PMC 5047364. PMID 27738400.