J Korean Ophthalmol Soc > Volume 50(12); 2009 > Article
Journal of the Korean Ophthalmological Society 2009;50(12):1881-1886.
DOI: https://doi.org/10.3341/jkos.2009.50.12.1881    Published online December 15, 2009.
Methazolamide-induced Stevens-Johnson Syndrome.
Young Seung Seo, Ki Cheol Chang, Moo Hwan Chang
Department of Ophthalmology, Dankook University College of Medicine, Cheonan, Korea. Happyeye21@medimail.co.kr
메타졸라마이드 복용 후 발생한 스티븐스-존슨 증후군
서영승ㆍ장기철ㆍ장무환
Department of Ophthalmology, Dankook University College of Medicine, Cheonan, Korea
Abstract
PURPOSE
To report three consecutive cases of methazolamide-induced Stevens-Johnson syndrome. CASE SUMMARY: We describe three patients who were all prescribed methazolamide for treatment of ophthalmologic conditions. A 29-year-old man and a 47- year-old woman were prescribed methazolamide (100 mg/day) for the treatment of central serous chorioretinopathy (CSCR). A 66-year-old woman was prescribed methazolamide (100 mg/day) for acute glaucoma of the left eye for approximately two weeks. After taking the methazolamide, three patients were showed the pururitic maculopapular rashes on the whole body and the vesicular eruptions of the oral mucosa and conjunctiva. On the basis of medication histories, characteristic skin lesions and mucosal involvement, we diagnosed all three patients with methazolamide-induced Stevens-Johnson syndrome. All three patients were hospitalized and treated with intravenous steroids and antihistamines. Two of the three cases showed conjunctival pseudomembranes. In two cases, the skin lesions worsened during the first week of treatment, and then resolved without complications over the next two to three weeks. The condition of the 47-year-old female patient deteriorated rapidly to toxic epidermal necrolysis due to sensitivity to sulfa antibiotics. HLA- A24, B59 and Cw1 were detected in all three cases. CONCLUSIONS: In 2008, domestic production of acetazolamide was halted in Korea. Because of this, methazolamide is expected to be prescribed by ophthalmologists more commonly than in previous years. Complete medical histories should be taken before prescribing methazolamide to patients. HLA typing should be conducted whenever possible to screen patients before prescription of methazolamide.
Key Words: HLA B59;Methazolamide;Stevens-Johnson syndrome


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