International Medical Case Reports Journal (Jun 2023)
Toxic Epidermal Necrolysis Associated with Misoprostol: A Case Report
Abstract
Okbu Frezgi,1 Mulugeta Russom2– 4 1Gynecology and Obstetric Unit, Orotta College of Medicine and Health Sciences, Asmara, Eritrea; 2Eritrean Pharmacovigilance Centre, National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea; 3Department of Medical Informatics, Erasmus Medical Centre, Rotterdam, the Netherlands; 4European Program for Pharmacovigilance and Pharmacoepidemiology, University of Bordeaux, Bordeaux, FranceCorrespondence: Mulugeta Russom, Eritrean Pharmacovigilance Centre, National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea, Tel +291-7197450, Email [email protected]: Misoprostol, a synthetic prostaglandin E1 analog, is currently used for medical termination of pregnancy. In the summary of the product characteristics of different market authorization holders of misoprostol tablets, approved by major regulators, serious mucocutaneous reactions, including toxic epidermal necrolysis are not documented as adverse effects. We are now reporting an unusual case of toxic epidermal necrolysis following the use of misoprostol 200 mcg tablets prescribed for termination of a pregnancy. A 25-year-old grand multipara woman from the Gash-Barka region of Eritrea visited Tesseney hospital with a history of amenorrhea that lasted for four months. She was admitted as a case of missed abortion for medical termination of pregnancy. Following three doses of misoprostol 200 mcg tablet the patient developed toxic epidermal necrolysis. Except misoprostol, no other possible alternatives that could explain the condition were identified. Accordingly, the adverse effect was judged to be possibly related to misoprostol. The patient recovered after four weeks of treatment without sequelae. Toxic epidermal necrolysis could, therefore, be a possible adverse effect of misoprostol that needs to be further investigated with better epidemiological studies.Keywords: missed abortion, misoprostol, toxic epidermal necrolysis, Eritrea
