Protonix may increase the risk of developing Stevens Johnson Syndrome, according a European study.

Protonix (pantoprazole) is used for treating heartburn by decreasing the body’s ability to produce stomach acid at the cellular level.

Stevens Johnson Syndrome, or SJS, is a rare but life-threatening drug reaction.

The 2008 study, “Stevens-Johnson syndrome and toxic epidermal necrolysis: assessment of medication risks with emphasis on recently marketed drugs. The EuroSCAR-study,” was published in the Journal of Investigational Dermatology, a peer-reviewed medical journal.

Researchers performed a case-control study, a type of study where researchers identify a case of a disease, then work backwards by finding very similar people who did not get the disease to try and find the cause. A case-control study is well suited for relatively rare reactions like Stevens Johnson Syndrome and Toxic Epidermal Necrolysis.

In this case, researchers used the term SCAR, or Sudden Cutaneous Adverse Reactions, to describe Stevens Johnson Syndrome, and a more severe form of the disorder called Toxic Epidermal Necrolysis, and several related disorders. Researchers compared results for a number of drugs, including Protonix.

Researchers found a possible link between Protonix and Stevens Johnson Syndrome, as well as related drug reactions. Researchers explained their results as a risk ratio. This means that researchers compared the odds of a person taking Protonix to a similar person who did not take the drug.

For Protonix, researchers found a risk ratio of 18. This means that patients taking Protonix were 18 times more likely to develop Stevens Johnson Syndrome than those who did not. Researchers did not find similar results for other drugs that fight heartburn in the same way.

Stevens Johnson Syndrome (SJS) is part of a family of rare autoimmune reactions. This means that in cases of Stevens Johnson Syndrome, the patient’s immune system goes haywire and attacks the patient’s own body.

In the case of Stevens Johnson Syndrome, the immune system attacks the largest organ of the body, the skin. SJS symptoms start with generalized, flu-like symptoms including chills, fever, and muscle aches. But SJS symptoms rapidly escalate to a painful rash with blisters, sores and ulcers.

Many cases also damage eyes and even internal organs. Particularly severe cases are called Toxic Epidermal Necrolysis, or TEN. In TEN, patches of skin die and slough off, leaving burn-like wounds. Both SJS and TEN may be fatal.

Though many aspects of SJS and TEN remain mysterious, it is known that the vast majority of cases are triggered by unusual reactions to drugs. Less often, it can be triggered by infection or very rarely by cancer. This study was among the first to implicate Protonix as a potential cause of SJS.

SJS and TEN are very serious conditions. They are both rare enough that treatment options are not well-researched. Some studies have indicated that steroids, often used in autoimmune reactions, may help, but this is not certain.

Most often, physicians have to resort to ending the medication and performing supportive therapy. Supportive therapy means treating the patient’s symptoms and keeping them comfortable.