Efficacy of intravenous immunoglobulins in a patient with systemic lupus erythematosus presenting with Stevens-Johnson syndrome

Abstract

DESCRIPTIONA 38-year-old woman with systemic lupus erythematosus (SLE) manifested by tiredness, polyarthritis, lymphopaenia, elevated antidouble-stranded DNA antibodies, and hypocomplementaemia was initiated on azathioprine and hydroxychloroquine. After 2 weeks of treatment, she developed extensive erythematous raised skin patches, facial oedema, and desquamation of nasal and oral mucosa. Both drugs were discontinued and she improved within 4-7 days. Since hydroxychloroquine is associated with more hypersensitivity reactions than azathioprine, the latter was reintroduced, but 2 days later, the patient developed severe recurrent skin lesions ( figure 1A-C). Skin biopsy showed band-like lymphocytic infiltrate with focal vacuolar interface

Untitled

“…This suggests genetic inclination to the varying manifestations of SJS [36]. Immunoglobulin preparations administered intravenously showed good outcomes in reduction of the duration of skin reactions and reduction of pathophysiological manifestations like symptoms [37][38][39]. Discontinuation of triggering substances and use of high dose corticosteroids has shown promising outcomes in therapy [40].…”

Anatomy, Physiology and Drugs Triangular Dynamics in Steven Johnsons Syndrome

“…36 Immunoglobulin preparations administered intravenously showed good outcomes in reduction of the duration of skin reactions and reduction of pathophysiological manifestations like symptoms. [37][38][39] Discontinuation of triggering substances and use of high dose corticosteroids has shown promising outcomes in therapy. 40 Adjuvant therapy like plasmapheresis has been beneficial in SJS cases.…”