Acute myocardial infarction following toxic epidermal necrolysis?

We describe a 29-year-old woman with rheumatoid arthritis who suffered an a cute myocardial infarction 70 days after an initial presentation with toxic epidermal necrolysis (TEN), The trigger for the TEN was probably an over-t he-counter antiinfluenza treatment containing tipepidine hibenzate. Althoug h the patient had familial hypercholesterolemia, we believe that thrombocyt osis, induced by the inflammatory response and metabolic stress resulting f rom the TEN, may also have played a significant role in the pathogenesis of the myocardial infarction. Although TEN manifests itself principally as a skin disease, the potential for systemic morbidity, including cardiovascula r abnormalities, should also be remembered.