Stevens-Johnson Syndrome Associated with Drugs and Vaccines in Children: A Case-Control Study

Francesca Menniti-Ippolito, Roberto Da Cas, Luciano Sagliocca, Giuseppe Traversa, Fernanda Ferrazin, Carmela Santuccio, Loriana Tartaglia, Francesco Trotta, Pasquale Di Pietro, Salvatore Renna, Rossella Rossi, Bianca Domenichini, Stefania Gamba, Francesco Trovato, Pier Angelo Tovo, Manuela Bianciotto, Carmelina Calitri, Clara Gabiano, Irene Raffaldi, Antonio UrbinoLiviana Da Dalt, Valentina Favero, Laura Giordano, Maura Baraldi, Federica Bertuola, Eleonora Lorenzon, Francesca Parata, Giorgio Perilongo, Silvia Vendramin, Monica Frassineti, Anna Maria Calvani, Elena Chiappini, Maurizio De Martino, Claudia Fancelli, Francesco Mannelli, Rachele Mazzantini, Sara Sollai, Elisabetta Venturini, Nicola Pirozzi, Umberto Raucci, Antonino Reale, Nadia Mores, Giulia Bersani, Adele Compagnone, Antonio Chiaretti, Riccardo Riccardi, Costantino Romagnoli, Vincenzo Tipo, Michele Dinardo, Fabiana Auricchio, Teresa Pisapia, Annalisa Capuano, Alessandra Maccariello, Elisabetta Parretta, Concita Rafaniello, Fortunata Fucà, Eleonora Di Rosa, Mario Furbetta, Piera Abate, Ilaria Leonardi

Research output: Contribution to journalArticle

Abstract

Objective:Stevens-Johnson Syndrome (SJS) is one of the most severe muco-cutaneous diseases and its occurrence is often attributed to drug use. The aim of the present study is to quantify the risk of SJS in association with drug and vaccine use in children.Methods:A multicenter surveillance of children hospitalized through the emergency departments for acute conditions of interest is currently ongoing in Italy. Cases with a diagnosis of SJS were retrieved from all admissions. Parents were interviewed on child's use of drugs and vaccines preceding the onset of symptoms that led to the hospitalization. We compared the use of drugs and vaccines in cases with the corresponding use in a control group of children hospitalized for acute neurological conditions.Results:Twenty-nine children with a diagnosis of SJS and 1,362 with neurological disorders were hospitalized between 1st November 1999 and 31st October 2012. Cases were more frequently exposed to drugs (79% vs 58% in the control group; adjusted OR 2.4; 95% CI 1.0-6.1). Anticonvulsants presented the highest adjusted OR: 26.8 (95% CI 8.4-86.0). Significantly elevated risks were also estimated for antibiotics use (adjusted OR 3.3; 95% CI 1.5-7.2), corticosteroids (adjusted OR 4.2; 95% CI 1.8-9.9) and paracetamol (adjusted OR 3.2; 95% CI 1.5-6.9). No increased risk was estimated for vaccines (adjusted OR: 0.9; 95% CI 0.3-2.8).Discussion:Our study provides additional evidence on the etiologic role of drugs and vaccines in the occurrence of SJS in children.

Original languageEnglish
Article numbere68231
JournalPLoS One
Volume8
Issue number7
DOIs
Publication statusPublished - Jul 16 2013

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Stevens-Johnson Syndrome
case-control studies
Case-Control Studies
Vaccines
vaccines
drugs
Pharmaceutical Preparations
Hospitalized Child
anticonvulsants
acetaminophen
Control Groups
nervous system diseases
adrenal cortex hormones
Acetaminophen
Nervous System Diseases
Skin Diseases
Anticonvulsants
Italy
Hospital Emergency Service
Adrenal Cortex Hormones

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Menniti-Ippolito, F., Da Cas, R., Sagliocca, L., Traversa, G., Ferrazin, F., Santuccio, C., ... Leonardi, I. (2013). Stevens-Johnson Syndrome Associated with Drugs and Vaccines in Children: A Case-Control Study. PLoS One, 8(7), [e68231]. https://doi.org/10.1371/journal.pone.0068231

Stevens-Johnson Syndrome Associated with Drugs and Vaccines in Children : A Case-Control Study. / Menniti-Ippolito, Francesca; Da Cas, Roberto; Sagliocca, Luciano; Traversa, Giuseppe; Ferrazin, Fernanda; Santuccio, Carmela; Tartaglia, Loriana; Trotta, Francesco; Di Pietro, Pasquale; Renna, Salvatore; Rossi, Rossella; Domenichini, Bianca; Gamba, Stefania; Trovato, Francesco; Tovo, Pier Angelo; Bianciotto, Manuela; Calitri, Carmelina; Gabiano, Clara; Raffaldi, Irene; Urbino, Antonio; Da Dalt, Liviana; Favero, Valentina; Giordano, Laura; Baraldi, Maura; Bertuola, Federica; Lorenzon, Eleonora; Parata, Francesca; Perilongo, Giorgio; Vendramin, Silvia; Frassineti, Monica; Calvani, Anna Maria; Chiappini, Elena; De Martino, Maurizio; Fancelli, Claudia; Mannelli, Francesco; Mazzantini, Rachele; Sollai, Sara; Venturini, Elisabetta; Pirozzi, Nicola; Raucci, Umberto; Reale, Antonino; Mores, Nadia; Bersani, Giulia; Compagnone, Adele; Chiaretti, Antonio; Riccardi, Riccardo; Romagnoli, Costantino; Tipo, Vincenzo; Dinardo, Michele; Auricchio, Fabiana; Pisapia, Teresa; Capuano, Annalisa; Maccariello, Alessandra; Parretta, Elisabetta; Rafaniello, Concita; Fucà, Fortunata; Di Rosa, Eleonora; Furbetta, Mario; Abate, Piera; Leonardi, Ilaria.

In: PLoS One, Vol. 8, No. 7, e68231, 16.07.2013.

Research output: Contribution to journalArticle

Menniti-Ippolito, F, Da Cas, R, Sagliocca, L, Traversa, G, Ferrazin, F, Santuccio, C, Tartaglia, L, Trotta, F, Di Pietro, P, Renna, S, Rossi, R, Domenichini, B, Gamba, S, Trovato, F, Tovo, PA, Bianciotto, M, Calitri, C, Gabiano, C, Raffaldi, I, Urbino, A, Da Dalt, L, Favero, V, Giordano, L, Baraldi, M, Bertuola, F, Lorenzon, E, Parata, F, Perilongo, G, Vendramin, S, Frassineti, M, Calvani, AM, Chiappini, E, De Martino, M, Fancelli, C, Mannelli, F, Mazzantini, R, Sollai, S, Venturini, E, Pirozzi, N, Raucci, U, Reale, A, Mores, N, Bersani, G, Compagnone, A, Chiaretti, A, Riccardi, R, Romagnoli, C, Tipo, V, Dinardo, M, Auricchio, F, Pisapia, T, Capuano, A, Maccariello, A, Parretta, E, Rafaniello, C, Fucà, F, Di Rosa, E, Furbetta, M, Abate, P & Leonardi, I 2013, 'Stevens-Johnson Syndrome Associated with Drugs and Vaccines in Children: A Case-Control Study', PLoS One, vol. 8, no. 7, e68231. https://doi.org/10.1371/journal.pone.0068231
Menniti-Ippolito F, Da Cas R, Sagliocca L, Traversa G, Ferrazin F, Santuccio C et al. Stevens-Johnson Syndrome Associated with Drugs and Vaccines in Children: A Case-Control Study. PLoS One. 2013 Jul 16;8(7). e68231. https://doi.org/10.1371/journal.pone.0068231
Menniti-Ippolito, Francesca ; Da Cas, Roberto ; Sagliocca, Luciano ; Traversa, Giuseppe ; Ferrazin, Fernanda ; Santuccio, Carmela ; Tartaglia, Loriana ; Trotta, Francesco ; Di Pietro, Pasquale ; Renna, Salvatore ; Rossi, Rossella ; Domenichini, Bianca ; Gamba, Stefania ; Trovato, Francesco ; Tovo, Pier Angelo ; Bianciotto, Manuela ; Calitri, Carmelina ; Gabiano, Clara ; Raffaldi, Irene ; Urbino, Antonio ; Da Dalt, Liviana ; Favero, Valentina ; Giordano, Laura ; Baraldi, Maura ; Bertuola, Federica ; Lorenzon, Eleonora ; Parata, Francesca ; Perilongo, Giorgio ; Vendramin, Silvia ; Frassineti, Monica ; Calvani, Anna Maria ; Chiappini, Elena ; De Martino, Maurizio ; Fancelli, Claudia ; Mannelli, Francesco ; Mazzantini, Rachele ; Sollai, Sara ; Venturini, Elisabetta ; Pirozzi, Nicola ; Raucci, Umberto ; Reale, Antonino ; Mores, Nadia ; Bersani, Giulia ; Compagnone, Adele ; Chiaretti, Antonio ; Riccardi, Riccardo ; Romagnoli, Costantino ; Tipo, Vincenzo ; Dinardo, Michele ; Auricchio, Fabiana ; Pisapia, Teresa ; Capuano, Annalisa ; Maccariello, Alessandra ; Parretta, Elisabetta ; Rafaniello, Concita ; Fucà, Fortunata ; Di Rosa, Eleonora ; Furbetta, Mario ; Abate, Piera ; Leonardi, Ilaria. / Stevens-Johnson Syndrome Associated with Drugs and Vaccines in Children : A Case-Control Study. In: PLoS One. 2013 ; Vol. 8, No. 7.
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abstract = "Objective:Stevens-Johnson Syndrome (SJS) is one of the most severe muco-cutaneous diseases and its occurrence is often attributed to drug use. The aim of the present study is to quantify the risk of SJS in association with drug and vaccine use in children.Methods:A multicenter surveillance of children hospitalized through the emergency departments for acute conditions of interest is currently ongoing in Italy. Cases with a diagnosis of SJS were retrieved from all admissions. Parents were interviewed on child's use of drugs and vaccines preceding the onset of symptoms that led to the hospitalization. We compared the use of drugs and vaccines in cases with the corresponding use in a control group of children hospitalized for acute neurological conditions.Results:Twenty-nine children with a diagnosis of SJS and 1,362 with neurological disorders were hospitalized between 1st November 1999 and 31st October 2012. Cases were more frequently exposed to drugs (79{\%} vs 58{\%} in the control group; adjusted OR 2.4; 95{\%} CI 1.0-6.1). Anticonvulsants presented the highest adjusted OR: 26.8 (95{\%} CI 8.4-86.0). Significantly elevated risks were also estimated for antibiotics use (adjusted OR 3.3; 95{\%} CI 1.5-7.2), corticosteroids (adjusted OR 4.2; 95{\%} CI 1.8-9.9) and paracetamol (adjusted OR 3.2; 95{\%} CI 1.5-6.9). No increased risk was estimated for vaccines (adjusted OR: 0.9; 95{\%} CI 0.3-2.8).Discussion:Our study provides additional evidence on the etiologic role of drugs and vaccines in the occurrence of SJS in children.",
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T1 - Stevens-Johnson Syndrome Associated with Drugs and Vaccines in Children

T2 - A Case-Control Study

AU - Menniti-Ippolito, Francesca

AU - Da Cas, Roberto

AU - Sagliocca, Luciano

AU - Traversa, Giuseppe

AU - Ferrazin, Fernanda

AU - Santuccio, Carmela

AU - Tartaglia, Loriana

AU - Trotta, Francesco

AU - Di Pietro, Pasquale

AU - Renna, Salvatore

AU - Rossi, Rossella

AU - Domenichini, Bianca

AU - Gamba, Stefania

AU - Trovato, Francesco

AU - Tovo, Pier Angelo

AU - Bianciotto, Manuela

AU - Calitri, Carmelina

AU - Gabiano, Clara

AU - Raffaldi, Irene

AU - Urbino, Antonio

AU - Da Dalt, Liviana

AU - Favero, Valentina

AU - Giordano, Laura

AU - Baraldi, Maura

AU - Bertuola, Federica

AU - Lorenzon, Eleonora

AU - Parata, Francesca

AU - Perilongo, Giorgio

AU - Vendramin, Silvia

AU - Frassineti, Monica

AU - Calvani, Anna Maria

AU - Chiappini, Elena

AU - De Martino, Maurizio

AU - Fancelli, Claudia

AU - Mannelli, Francesco

AU - Mazzantini, Rachele

AU - Sollai, Sara

AU - Venturini, Elisabetta

AU - Pirozzi, Nicola

AU - Raucci, Umberto

AU - Reale, Antonino

AU - Mores, Nadia

AU - Bersani, Giulia

AU - Compagnone, Adele

AU - Chiaretti, Antonio

AU - Riccardi, Riccardo

AU - Romagnoli, Costantino

AU - Tipo, Vincenzo

AU - Dinardo, Michele

AU - Auricchio, Fabiana

AU - Pisapia, Teresa

AU - Capuano, Annalisa

AU - Maccariello, Alessandra

AU - Parretta, Elisabetta

AU - Rafaniello, Concita

AU - Fucà, Fortunata

AU - Di Rosa, Eleonora

AU - Furbetta, Mario

AU - Abate, Piera

AU - Leonardi, Ilaria

PY - 2013/7/16

Y1 - 2013/7/16

N2 - Objective:Stevens-Johnson Syndrome (SJS) is one of the most severe muco-cutaneous diseases and its occurrence is often attributed to drug use. The aim of the present study is to quantify the risk of SJS in association with drug and vaccine use in children.Methods:A multicenter surveillance of children hospitalized through the emergency departments for acute conditions of interest is currently ongoing in Italy. Cases with a diagnosis of SJS were retrieved from all admissions. Parents were interviewed on child's use of drugs and vaccines preceding the onset of symptoms that led to the hospitalization. We compared the use of drugs and vaccines in cases with the corresponding use in a control group of children hospitalized for acute neurological conditions.Results:Twenty-nine children with a diagnosis of SJS and 1,362 with neurological disorders were hospitalized between 1st November 1999 and 31st October 2012. Cases were more frequently exposed to drugs (79% vs 58% in the control group; adjusted OR 2.4; 95% CI 1.0-6.1). Anticonvulsants presented the highest adjusted OR: 26.8 (95% CI 8.4-86.0). Significantly elevated risks were also estimated for antibiotics use (adjusted OR 3.3; 95% CI 1.5-7.2), corticosteroids (adjusted OR 4.2; 95% CI 1.8-9.9) and paracetamol (adjusted OR 3.2; 95% CI 1.5-6.9). No increased risk was estimated for vaccines (adjusted OR: 0.9; 95% CI 0.3-2.8).Discussion:Our study provides additional evidence on the etiologic role of drugs and vaccines in the occurrence of SJS in children.

AB - Objective:Stevens-Johnson Syndrome (SJS) is one of the most severe muco-cutaneous diseases and its occurrence is often attributed to drug use. The aim of the present study is to quantify the risk of SJS in association with drug and vaccine use in children.Methods:A multicenter surveillance of children hospitalized through the emergency departments for acute conditions of interest is currently ongoing in Italy. Cases with a diagnosis of SJS were retrieved from all admissions. Parents were interviewed on child's use of drugs and vaccines preceding the onset of symptoms that led to the hospitalization. We compared the use of drugs and vaccines in cases with the corresponding use in a control group of children hospitalized for acute neurological conditions.Results:Twenty-nine children with a diagnosis of SJS and 1,362 with neurological disorders were hospitalized between 1st November 1999 and 31st October 2012. Cases were more frequently exposed to drugs (79% vs 58% in the control group; adjusted OR 2.4; 95% CI 1.0-6.1). Anticonvulsants presented the highest adjusted OR: 26.8 (95% CI 8.4-86.0). Significantly elevated risks were also estimated for antibiotics use (adjusted OR 3.3; 95% CI 1.5-7.2), corticosteroids (adjusted OR 4.2; 95% CI 1.8-9.9) and paracetamol (adjusted OR 3.2; 95% CI 1.5-6.9). No increased risk was estimated for vaccines (adjusted OR: 0.9; 95% CI 0.3-2.8).Discussion:Our study provides additional evidence on the etiologic role of drugs and vaccines in the occurrence of SJS in children.

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