Seeking your SJS expertise.

[Healer941]

Hi! I am researching Stevens-Johnson Syndrome and am confused by its relationship to low bicarb levels. The SCORTEN scale suggests that bicrb values <20 translate to poorer outcomes. Why is this the case and how does the pathology of SJS decrease the serum bicarb. I appreciate your help.

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[Stitch]

I doubt the low bicarb is a direct result of SJS, though you do see some electrolyte imbalances due to increased transepidermal water loss. More likely those with low bicarb are sicker and more acidotic due to all the other problems that SJS causes. Sepsis would be one reason, but so would multiorgan compromise. Remember that risk factors may be associated with outcomes and not directly causative.