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S. Suniti
Faculty of Dentistry, Universitas Padjadjaran, Bandung
Dentistry

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Herbal-induced Stevens-Johnson syndrome with oral involvement and management in an HIV patient S. Suniti; Irna Sufiawati
Dental Journal (Majalah Kedokteran Gigi) Vol. 51 No. 3 (2018): September 2018
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (439.31 KB) | DOI: 10.20473/j.djmkg.v51.i3.p153-157

Abstract

Background: Stevens-Johnson syndrome (SJS) is an immune complex-mediated hypersensitivity reaction affecting the skin and mucous membranes. Patients infected with human immunodeficiency virus (HIV) are at increased risk of developing SJS which is predominantly caused by an adverse reaction to medications, including herbal varieties. In recent years, the consumption of herbal medicines has increased, while their safety remains a matter for investigation. Purpose: The purpose of this case report is to explain the occurrence of SJS caused by herbal medicine. Case: A 43-year-old male patient with body-wide skin erosion was referred to the Department of Oral Medicine and subsequently diagnosed with Stevens-Johnson syndrome due to his consumption of a herbal medicine containing zingiber rhizoma, coboti rhizoma, asari herbal and epimedi. The patient’s chief complaints included difficulty when opening the mouth, dysphagia and excessive production of saliva continuously contaminated with blood and sputum. Extraoral examination showed a sanguinolenta crust on the lips. Intra oral examination of oral mucous showed erosive lesions with bleeding and pain. A HIV test performed at a Clinical Pathology Laboratory was positive for antibodies against HIV with a CD4 cell count of 11 cells/ml. Case management: Treatment consisted of the administering of NaCl 0.9 %, hydrocortisone 0.1% and Chlorhexidine digluconate 0.12% for 12  days. Conclusion: SJS can be caused by herbal medicine and it is essential to be aware of the latter’s potential adverse effects, especially in immunocompromised patients. Symptomatic management of oral lesions should be planned as an early intervention in order to decrease morbidity and mortality in SJS patients.
Analysis of the relationship between human cytomegalovirus DNA and gB-1 genotype in the saliva of HIV/AIDS patients with xerostomia and salivary flow rate Irna Sufiawati; S. Suniti; Revi Nelonda; Rudi Wisaksana; Agnes Rengga Rendati; Riezki Amalia; Isabellina Dwades Tampubolon
Dental Journal (Majalah Kedokteran Gigi) Vol. 52 No. 4 (2019): December 2019
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/j.djmkg.v52.i4.p197-203

Abstract

Background: Human immunodeficiency virus (HIV) infection increases vulnerability to opportunistic viral infection, including Human cytomegalovirus (HCMV) infection, that has been detected in saliva. The HCMV envelope glycoprotein B (gB) is highly immunogenic and has been associated with HCMV-related diseases. Purpose: The purpose of this study is to assess the prevalence of HCMV and gB-1 genotype in the saliva of HIV/AIDS patients and to analyse their relationship with xerostomia and salivary flow rate (SFR). Methods: This cross-sectional study involved 34 HIV/AIDS patients. Saliva was tested for the presence of HCMV DNA using PCR microarrays, and nested PCR for gB-1 genotype detection. Xerostomia was measured using a Fox’s questionnaire. Unstimulated whole saliva flow rate was measured by means of the spitting method. Results: The composition of the research population consisting of 73.5% males and 26.5% females with HIV/AIDS. HCMV was found in 64.7% of HIV/AIDS patients, while gB-1 genotype was detected in 59.1%. Xerostomia was closely associated with the presence of HCMV in saliva (p<0.05), but not with gB-1. There was no significant relationship between xerostomia and SFR rates in the research subjects with HCMV positive saliva (p> 0.05). Conclusion: The presence of xerostomia-associated HCMV in saliva was elevated among HIV/AIDS patients. Further investigation is required to identify other gB genotypes that may be responsible for xerostomia and SFR changes in HIV/AIDS patients.
Co-Authors Agnes Rengga Rendati Irna Sufiawati Isabellina Dwades Tampubolon Revi Nelonda Riezki Amalia Rudi Wisaksana