Critical Review: Systemic Medical Neglect in Lab-Confirmed Antiphospholipid Syndrome (APS) with von Willebrand Factor (vWF) Abnormalities and Stevens-Johnson Syndrome (SJS)
1. Overview This review examines the intersection of underdiagnosed autoimmune diseases, coagulation disorders, and drug-induced adverse reactions, with particular emphasis on patients with laboratory-confirmed Antiphospholipid Syndrome (APS) and abnormalities of von Willebrand factor (vWF) . Special attention is given to cases of Stevens-Johnson Syndrome (SJS) induced by medications such as allopurinol and methotrexate (MTX) , both of which are recognized, although uncommon, causes of this severe hypersensitivity reaction. The review also explores the potential influence of cytochrome P450 gene polymorphisms , particularly CYP3A4 and CYP11A1 variants, on blood concentrations of hydroxychloroquine and its metabolites, and how these genetic differences may contribute to adverse drug reactions. Hydroxychloroquine has been associated with Stevens-Johnson Syndrome (SJS) , although this is an exceptionally rare adverse effect. SJS is a severe and potentially life-threatening muco...