Korean J Dermatol.  2002 Jul;40(7):766-771.

The Effect of High-Dose Intravenous Immunoglobulin for the Treatment of Toxic Epidermal Necrolysis

• Kim KJ
• Jee MS
• Han MH
• Choi JH
• Sung KJ
• Moon KC
• Koh JK

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.

Keyword

Toxic epidermal necrolysis; High-dose intravenous immunoglobulin

MeSH Terms

Anemia, Hemolytic
Diagnosis
Headache
Humans
Immunoglobulins*
Critical Care
Mortality
Myalgia
Nausea
Neutropenia
Sepsis
Skin
Stevens-Johnson Syndrome*
Wound Healing
Immunoglobulins