{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T06:50:45Z","timestamp":1778827845541,"version":"3.51.4"},"reference-count":32,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T00:00:00Z","timestamp":1644537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>A 41-year-old man was treated with prednisolone (PSL) and multimatrix (MMX) mesalamine for remission induction therapy of ulcerative colitis. PSL was tapered due to successful remission induction treatment. During the treatment course, ocular foreign body sensation, eyelid swelling, ocular conjunctiva hyperemia, facial redness and swelling, watery nasal discharge, stomatitis, anal pain, and reddish puffiness on the bilateral dorsum of the hands appeared, and he was diagnosed with Stevens\u2013Johnson syndrome (SJS). SJS was improved by PSL treatment and intravenous immunoglobulin. MMX mesalamine was the causative agent by drug-induced lymphocyte stimulation test. This is the first reported case of SJS with MMX mesalamine.<\/jats:p>","DOI":"10.3390\/medicina58020276","type":"journal-article","created":{"date-parts":[[2022,2,13]],"date-time":"2022-02-13T20:34:45Z","timestamp":1644784485000},"page":"276","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Case of Stevens\u2013Johnson Syndrome Complicated with Multimatrix System Mesalamine in Ulcerative Colitis"],"prefix":"10.3390","volume":"58","author":[{"given":"Mimari","family":"Kanazawa","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu 321-0293, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3716-3386","authenticated-orcid":false,"given":"Keiichi","family":"Tominaga","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu 321-0293, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Kanamori","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu 321-0293, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3714-1208","authenticated-orcid":false,"given":"Takanao","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu 321-0293, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Masuyama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu 321-0293, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoko","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu 321-0293, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiichiro","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu 321-0293, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5158-5606","authenticated-orcid":false,"given":"Akira","family":"Yamamiya","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu 321-0293, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0350-3151","authenticated-orcid":false,"given":"Kenichi","family":"Goda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu 321-0293, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2271-2717","authenticated-orcid":false,"given":"Atsushi","family":"Irisawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Dokkyo Medical University, 880 Kitakobayashi, Mibu 321-0293, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/0140-6736(90)91521-B","article-title":"Preliminary report: Cyclosporin in treatment of severe active ulcerative colitis","volume":"336","author":"Lichtiger","year":"1990","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1056\/NEJM199411103311906","article-title":"Severe adverse cutaneous reactions to drugs","volume":"331","author":"Roujeau","year":"1994","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1001\/archderm.1995.01690170041005","article-title":"Erythema multiforme with mucous membrane involvement and Stevens-Johnson syndrome are clinically different disorders with distinct causes","volume":"131","author":"Assier","year":"1995","journal-title":"Arch. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1111\/bjd.14530","article-title":"U.K. guidelines for the management of Stevens-Johnson syndrome\/toxic epidermal necrolysis in adults 2016","volume":"174","author":"Creamer","year":"2016","journal-title":"Br. J. Dermatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/j.medcli.2010.12.007","article-title":"S\u00edndrome de Stevens-Johnson y necr\u00f3lisis epid\u00e9rmica t\u00f3xica: Revisi\u00f3n de la experiencia cl\u00ednica en un Hospital Universitario (1989\u20132008) [Stevens-Johnson syndrome and toxic epidermal necrolysis: A review of the clinical experience of a University Hospital (1989\u20132008)]","volume":"136","author":"Palao","year":"2011","journal-title":"Med. Clin."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1001\/archderm.1987.01660330071012","article-title":"Toxic epidermal necrolysis. Clinical findings and prognosis factors in 87 patients","volume":"123","author":"Revuz","year":"1987","journal-title":"Arch. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1016\/S0161-6420(95)30811-1","article-title":"Analysis of the acute ophthalmic manifestations of the erythema multiforme\/Stevens-Johnson syndrome\/toxic epidermal necrolysis disease spectrum","volume":"102","author":"Power","year":"1995","journal-title":"Ophthalmology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1016\/j.ophtha.2006.10.029","article-title":"New grading system for the evaluation of chronic ocular manifestations in patients with Stevens-Johnson syndrome","volume":"114","author":"Sotozono","year":"2007","journal-title":"Ophthalmology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1001\/archderm.1987.01660330082014","article-title":"Genetic susceptibility to toxic epidermal necrolysis","volume":"123","author":"Roujeau","year":"1987","journal-title":"Arch. Dermatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"4862","DOI":"10.1038\/srep04862","article-title":"Independent strong association of HLA-A*02:06 and HLA-B*44:03 with cold medicine-related Stevens-Johnson syndrome with severe mucosal involvement","volume":"4","author":"Ueta","year":"2014","journal-title":"Sci. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"5981","DOI":"10.1038\/srep05981","article-title":"Trans-ethnic study confirmed independent associations of HLA-A*02:06 and HLA-B*44:03 with cold medicine-related Stevens-Johnson syndrome with severe ocular surface complications","volume":"4","author":"Ueta","year":"2014","journal-title":"Sci. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"273","DOI":"10.5217\/ir.2018.16.2.273","article-title":"Evaluation of the drug-induced lymphocyte stimulation test for diagnosing mesalazine allergy","volume":"16","author":"Saito","year":"2018","journal-title":"Intest. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1177\/014107688007300811","article-title":"Toxic epidermal necrolysis, agranulocytosis and erythroid hypoplasia associated with sulphasalazine","volume":"73","author":"Maddocks","year":"1980","journal-title":"J. R. Soc. Med."},{"key":"ref_14","first-page":"1029","article-title":"Sulfasalazine desensitization in children and adolescents with chronic inflammatory bowel disease","volume":"87","author":"Tolia","year":"1992","journal-title":"Am. J. Gastroenterol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1097\/01.mib.0000231569.43065.a4","article-title":"Erythroderma and toxic epidermal necrolysis caused by to 5-aminosalacylic acid","volume":"12","author":"Iemoli","year":"2006","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1002\/ibd.20125","article-title":"Toxic epidermal necrosis associated with mesalamine in a patient with ulcerative colitis","volume":"13","author":"Fukunaga","year":"2007","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.crohns.2011.03.014","article-title":"Stevens-Johnson syndrome with sulfasalazine treatment: Report of two cases","volume":"5","author":"Tremblay","year":"2011","journal-title":"J. Crohns Colitis"},{"key":"ref_18","first-page":"413","article-title":"Stevens Johnson syndrome-Toxic Epidermal Necrolysis Overlap induced by sulfasalazine treatment: A case report","volume":"93","author":"Zizi","year":"2015","journal-title":"Tunis. Med."},{"key":"ref_19","first-page":"736","article-title":"Topical mesalazine as a cause of Stevens-Johnson syndrome","volume":"110","author":"Trigo","year":"2018","journal-title":"Rev. Esp. Enferm. Dig."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1093\/ecco-jcc\/jjx148","article-title":"Salazosulphapyridine-related Stevens-Johnson Syndrome Caused by Sulphapyridine and Confirmed by Enzyme-linked Immunospot Assay","volume":"12","author":"Xiong","year":"2018","journal-title":"J. Crohns Colitis"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"211","DOI":"10.5152\/tjg.2018.17728","article-title":"Stevens-Johnson syndrome on treatment with sulfasalazine for Crohn\u2019s disease: Need for a multidisciplinary approach","volume":"30","author":"Viola","year":"2019","journal-title":"Turk. J. Gastroenterol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1177\/1756283X17709974","article-title":"MMX\u00ae technology and its applications in gastrointestinal diseases","volume":"10","author":"Nardelli","year":"2017","journal-title":"Therap. Adv. Gastroenterol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1007\/s10620-015-3897-0","article-title":"Budesonide Multi-matrix for the Treatment of Patients with Ulcerative Colitis","volume":"61","author":"Lichtenstein","year":"2016","journal-title":"Dig. Dis. Sci."},{"key":"ref_24","first-page":"CD007698","article-title":"Oral budesonide for induction of remission in ulcerative colitis","volume":"26","author":"Sherlock","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1053\/j.gastro.2012.08.003","article-title":"Once-daily budesonide MMX\u00ae extended-release tablets induce remission in patients with mild to moderate ulcerative colitis: Results from the CORE I study","volume":"143","author":"Sandborn","year":"2012","journal-title":"Gastroenterology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1136\/gutjnl-2012-304258","article-title":"Once-daily budesonide MMX in active, mild-to-moderate ulcerative colitis: Results from the randomised CORE II study","volume":"63","author":"Travis","year":"2014","journal-title":"Gut"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1111\/j.1365-2036.2008.03757.x","article-title":"Oral, colonic-release low-molecular-weight heparin: An initial open study of Parnaparin-MMX for the treatment of mild-to-moderate left-sided ulcerative colitis","volume":"28","author":"Pastorelli","year":"2008","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1111\/jtm.12168","article-title":"Targeting of rifamycin SV to the colon for treatment of travelers\u2019 diarrhea: A randomized, double-blind, placebo-controlled phase 3 study","volume":"21","author":"DuPont","year":"2014","journal-title":"J. Travel. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.jdermsci.2012.04.002","article-title":"Recent advances in the genetics and immunology of Stevens-Johnson syndrome and toxic epidermal necrosis","volume":"66","author":"Chung","year":"2012","journal-title":"J. Dermatol. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1038\/nm1208-1311","article-title":"Saving the skin from drug-induced detachment","volume":"14","author":"Nickoloff","year":"2008","journal-title":"Nat. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2331","DOI":"10.1001\/jama.2011.1692","article-title":"Initiation of tumor necrosis factor-\u03b1 antagonists and the risk of hospitalization for infection in patients with autoimmune diseases","volume":"306","author":"Grijalva","year":"2011","journal-title":"JAMA"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1097\/00007890-197810000-00013","article-title":"Effect of corticosteroids on the human immune response. Suppression of mitogen-induced lymphocyte proliferation by \u201cpulse\u201d methylprednisolone","volume":"26","author":"Fan","year":"1978","journal-title":"Transplantation"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/2\/276\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:17:39Z","timestamp":1760134659000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/2\/276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,11]]},"references-count":32,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["medicina58020276"],"URL":"https:\/\/doi.org\/10.3390\/medicina58020276","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,11]]}}}