A girl on sulphonamides developed abdominal pain and presented to emergency with seizure. What is the probable cause?
## **Core Concept**
The question tests the understanding of drug-induced complications, specifically those related to sulfonamide antibiotics. Sulfonamides are known to cause various adverse reactions, including hypersensitivity reactions, which can manifest as severe cutaneous adverse reactions, serum sickness-like reactions, and in rare cases, more severe systemic reactions.
## **Why the Correct Answer is Right**
The correct answer, **D. Stevens-Johnson syndrome**, is a severe skin and mucous membrane disorder usually triggered by medications, including sulfonamides. It can present with prodromal symptoms such as fever, malaise, and abdominal pain, followed by the development of skin and mucous membrane lesions. Seizures can occur due to systemic involvement and potential electrolyte imbalances. Stevens-Johnson syndrome is a type of toxic epidermal necrolysis (TEN) and is a medical emergency.
## **Why Each Wrong Option is Incorrect**
- **Option A:** While anaphylaxis can cause abdominal pain and potentially lead to seizures due to hypoxia or hypotension, it typically presents with urticaria, angioedema, and cardiovascular collapse, which are not mentioned in the scenario.
- **Option B:** Serum sickness-like reaction can present with fever, arthralgias, and rash but is less commonly associated with seizures and severe mucocutaneous lesions.
- **Option C:** Toxic epidermal necrolysis (TEN) is closely related to Stevens-Johnson syndrome but is generally considered a more severe form with a higher percentage of body surface area affected. While seizures can occur, the question's context and typical presentations guide the differentiation.
## **Clinical Pearl / High-Yield Fact**
A key clinical pearl is that Stevens-Johnson syndrome and toxic epidermal necrolysis are considered medical emergencies requiring immediate withdrawal of the offending drug, supportive care, and sometimes specific treatments like intravenous immunoglobulins. Early recognition is crucial for management and potentially saving lives.
## **Correct Answer:** D. Stevens-Johnson syndrome.