Korean J Asthma Allergy Clin Immunol.  2009 Dec;29(4):256-261.

High-Dose Intravenous Immunoglobulin in the Treatment of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Abstract

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 to5 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.

MeSH Terms

Epidermal Necrolysis, Toxic
Humans
Immunoglobulins
Immunoglobulins, Intravenous
Length of Stay
Retrospective Studies
Stevens-Johnson Syndrome
Immunoglobulins
Immunoglobulins, Intravenous