[Use of intravenous immunoglobulin for the treatment of toxic epidermal necrolysis and Stevens-Johnson/toxic epidermal necrolysis overlap syndrome. Review of 15 cases].

Abstract:

BACKGROUND:Toxic epidemial necrolysis (TEN) is an acute adverse drug reaction, that has an unpredictableprogression and a 30% mortality. The incidence of TEN in the general population is approximately 0.4 to 1.2 cases/million/year. It is characterized pathologically by keratinocyte apoptosis which leads to epidemial detachment. Keratinocyte apoptosis is triggered by activation of the Fas-FasL, pathway and could be prevented by the use of intravenous immunoglobulin (IVIG). AIM:To report the experience with the use of IVIG in TEN. MATERIAL AND METHODS:Retrospective study of 15 patients with a diagnosis of Stevens-Johnson/TEN overlap (SJS/TEN) or TEN, that received a total dose of 23 +/- 0.6 mg/kg ofIVIG over aperiod of 3 to 4 days. The infusión was initiated during thefirst 24 hours after diagnosis and was associated with standard care for burn victims. Steroids were avoided if the patient was not in chronic steroidal therapy. RESULTS:Allpatients responded to IVIG in a lapse of 46.4 +/- 14.2 hours from the beginning of infusión. Eighty percent of patients survived, but one developed acute renal failure due to IVIG, and another became blind due to corneal opacities, a complication of TEN. Those who survived were discharged after a lapse of 19-8 +/- 6.6 days from the beginning ofthe disease. CONCLUSIONS:Despite the lack of blind, multicentric and randomized triáis, we agree with some international studies that TVIG is beneficial as a treatment for SSJ/NETand TEN .

journal_name

Rev Med Chil

journal_title

Revista medica de Chile

authors

Molgó M,Carreño N,Hoyos-Bachiloglu R,Andresen M,González S

doi

/S0034-98872009000300009

subject

Has Abstract

pub_date

2009-03-01 00:00:00

pages

383-9

issue

3

eissn

0034-9887

issn

0717-6163

pii

S0034-98872009000300009

journal_volume

137

pub_type

杂志文章
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    authors: Medina Lois E

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    authors: Toro L,Jara C,Adauy A,Henríquez A,Trujillo F,Child R,Ortiz E

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  • [Non-specific cecal ulcer in a patient with chronic renal failure in hemodialysis treatment. Case report].

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    authors: Bannura G,Melo C,Villamán J,Muñoz M,Levy I

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    pub_type: 临床试验,杂志文章,随机对照试验

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  • [Survival of diabetic patients with known coronary artery disease].

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    authors: Cartier L,Hernández JE,Stuardo A,González J,Villagra R

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  • [Results of acute myeloid leukemia treatment. Analysis of 63 patients between 2010-2014].

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  • [Small-for-size syndrome. Report of one case].

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    doi:/S0034-98872010000400016

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