Asymptomatic Hyperamylasemia in Stevens-Johnson Syndrome Is Associated with Intestinal Barrier Dysfunction

Abstract

Background/Objectives. Stevens-Johnson syndrome (SJS) is an allergic disease characterized by extensive epidermal detachment and mucositis. SJS involves both the skin and mucosal membranes, including the gastrointestinal tract. The present study is aimed at understanding the underlying reason of asymptomatic hyperamylasemia in patients with SJS, which may be associated with mucosal injury of the GI tract. Methods. A retrospective study on SJS patients was conducted at a tertiary medical center. All patients diagnosed as SJS, with available serum amylase index, were included. Clinical data of all subjects were retrospectively collected and analyzed. Colonic mucosal biopsies were obtained to measure tight junction protein expression. Results. A total of nine patients were included in the present study for study analysis. The average serum amylase of the study cohort was $228.78\pm 204.18\text{U}/\text{L}$ . Among which, five patients had a positive fecal occult blood test (FOBT). Colonic mucosal biopsies were obtained and stained with occludin and zonula occludens-1 (ZO-1). The expression of occludin and ZO-1 was significantly downregulated in SJS patients ( $p<0.01$ ), which was indicative of intestinal barrier dysfunction. Conclusion. Hyperamylasemia often extends beyond pancreatic diseases. Clinical awareness of asymptomatic hyperamylasemia secondary to other systemic diseases can help avoid unnecessary overexamination and overtreatment.