Steven Johnson Syndrome (SJS) is primarily caused by an abnormal immune system reaction, usually triggered by certain medications or infections. The most common medication triggers include antibiotics (especially penicillins and sulfa drugs), anticonvulsants (such as carbamazepine, phenytoin, lamotrigine), pain relievers (like acetaminophen and NSAIDs), and gout medicines (like allopurinol). Infectious triggers include viral infections such as herpes simplex virus, Epstein-Barr virus, influenza, and bacterial infections like Mycoplasma pneumoniae. Genetic predispositions and immune system abnormalities also play important roles in making some individuals more susceptible to developing SJS.
Key points about causes:
- Medications are the most common cause, particularly certain antibiotics, anticonvulsants, NSAIDs, and gout treatment drugs.
- Viral and bacterial infections can also trigger the syndrome, more frequently in children.
- Genetic factors related to immune system genes (like certain HLA types) increase susceptibility.
- Sometimes no specific cause can be identified.
This immune-driven reaction causes keratinocyte apoptosis leading to the characteristic skin rash and mucous membrane damage seen in SJS.
