Case of fertility treatment-induced Stevens-Johnson syndrome with a severe ocular complication

J Dermatol. 2019 Nov;46(11):1042-1045. doi: 10.1111/1346-8138.15072. Epub 2019 Sep 5.

Abstract

Pharmacological regimens with multiple medications are being used in fertility treatments. Herein, we report a case of a 40-year-old Japanese woman who developed Stevens-Johnson syndrome (SJS) with a severe ocular complication during fertility treatment. Despite early multimodal interventions, including methylprednisolone pulse therapy and plasma exchange, her ocular complications persisted for more than a year. The four drugs administered in this case (cabergoline, medroxyprogesterone acetate, clomiphene, and intravenous human chorionic gonadotropin) have never been reported to induce SJS. Based on this case, we suggest that obstetricians, gynecologists, and dermatologists should be aware of fertility treatment-induced severe drug eruptions.

Keywords: Stevens-Johnson syndrome; adverse drug reaction; infertility; keratoconjunctivitis; plasma exchange.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / administration & dosage
  • Cabergoline / administration & dosage
  • Cabergoline / adverse effects
  • Cefdinir / administration & dosage
  • Chorionic Gonadotropin / administration & dosage
  • Chorionic Gonadotropin / adverse effects
  • Clomiphene / administration & dosage
  • Clomiphene / adverse effects
  • Drug Therapy, Combination / adverse effects
  • Eye Diseases / chemically induced*
  • Eye Diseases / therapy
  • Female
  • Fertility Agents, Female / adverse effects*
  • Fertility Agents, Female / therapeutic use
  • Glucocorticoids / administration & dosage
  • Humans
  • Infertility, Female / drug therapy*
  • Medroxyprogesterone Acetate / administration & dosage
  • Medroxyprogesterone Acetate / adverse effects
  • Plasma Exchange
  • Stevens-Johnson Syndrome / etiology*
  • Stevens-Johnson Syndrome / therapy

Substances

  • Anti-Inflammatory Agents
  • Chorionic Gonadotropin
  • Fertility Agents, Female
  • Glucocorticoids
  • Clomiphene
  • Medroxyprogesterone Acetate
  • Cefdinir
  • Cabergoline