The Effect of High-Dose Intravenous Immunoglobulin for the Treatment of Toxic Epidermal Necrolysis.
- Author:
Kyoung Jin KIM
1
;
Min Sun JEE
;
Man Heui HAN
;
Jee Ho CHOI
;
Kyung Jeh SUNG
;
Kee Chan MOON
;
Jai Kyoung KOH
Author Information
1. Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Korea. kimkj20@dreamwiz.com
- Publication Type:Original Article
- Keywords:
Toxic epidermal necrolysis;
High-dose intravenous immunoglobulin
- MeSH:
Anemia, Hemolytic;
Diagnosis;
Headache;
Humans;
Immunoglobulins*;
Critical Care;
Mortality;
Myalgia;
Nausea;
Neutropenia;
Sepsis;
Skin;
Stevens-Johnson Syndrome*;
Wound Healing
- From:Korean Journal of Dermatology
2002;40(7):766-771
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Toxic epidermal necrolysis(TEN) is the most dramatic and life-threatening cutaneous drug reaction. However, specific and effective treatment for TEN have not yet been identified. Recently several reports suggested that high dose intravenous immunoglobulin(IV Ig) treatment has produced good results in patients with TEN. OBJECTIVE: To analyze the efficacy and side effects of IV Ig in treatement of TEN. METHODS: Ten patients with clinicopathological diagnosis of TEN were treated with IV Ig(1.6-3.4g/kg), and clinical efficacy and side effects were observed. RESULTS: Nine patients were healed and one died of sepsis. Interruption of further epidermal detachment occurred after an average 3 days from the onset of IV Ig therapy. Complete wound healing occurred after an average of 14.3 days. The side effects of IV Ig including headache, myalgia, nausea, transient neutropenia, and coombs positive hemolytic anemia were observed in 4 patients but normalized after cessation of IV Ig therapy. Three of them showed complete healing of detached skin but died with aggravation of underlying disease. CONCLUSION: IV Ig therapy represents a safe and very effective treatment for TEN. Furthermore, intensive care for underlying diseases is also very important for reducing the mortality rate in patients with TEN.
