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KMID : 0854720090290040256
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Korean Journal of Asthma, Allergy and Clinical Immunology
2009 Volume.29 No. 4 p.256 ~ p.261
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High-Dose Intravenous Immunoglobulin in the Treatment of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis
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Lee Su-Mi
Um Soo-Jung
Lee Soo-Keol
Kim Ki-Ho
Kim Young-Hun
Son Choon-Hee
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Abstract
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Background: There have been some uncontrolled studies on clinical efficacy of high-dose intravenous immunoglobulin (IVIG) in patients with Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN).
Objective: This study was conducted to demonstrate the effectiveness of high-dose IVIG therapy in reducing mortality in Korean patients with SJS or TEN.
Method: Retrospective data from 2 patients with SJS, 4 patients with SJS/TEN and 3 patients with TEN treated with high-dose IVIG were analyzed.
Result: The total dose of IVIG administered was 1.0 gm/kg/day from 2 days to 1.0 gm/kg for 7 days. Of the 8 patients who showed good responses to IVIG, the mean time to objective responses was 2.0±1.4 days (range, 1 to 5 days). The length of stay in hospital was 22.8±9.2 days (range, 11 to 40 days). Two patients had poor outcomes. Based on the SCORTEN system, 3.2 patients (39.9%) were expected to die, but 2.0 patients (25.0%) died. However, there was no statistical significance (P＞0.05).
Conclusion: Therapy with high-dose IVIG showed a slightly improved mortality in patients with SJS, SJS/TEN overlap and TEN, but there was no statistical significance (P＞0.05). Although dramatic clinical improvement was noted in most patients, further nationwide multicenter clinical trials are required to evaluate the effectiveness of high-dose IVIG in the treatment of patients with SJS or TEN.
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KEYWORD
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Stevens-Johnson syndrome, Epidermal necrolysis, Immunoglobulins
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