Toxic Epidermal Necrolysis Therapy with TPE and IVIG—10 Years of Experience of the Burns Treatment Center

Krajewski, Andrzej; Mazurek, Maciej; Mlynska-Krajewska, Elzbieta; Piorun, Krzysztof; Knakiewicz, Mateusz; Markowska, Marta

doi:10.1093/jbcr/irz073

Cited by 13 publications

(9 citation statements)

References 38 publications

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“…SCORTEN scores of our patients ranged between 2 and 5 and the mean value was 3.1. The mean SCORTEN was reported as 2.4,[ 7 ] 1.9,[ 8 ] 2.52,[ 19 ] and 2.9[ 20 ] (in the TEN group) in the other studies. The reason for the higher SCORTEN value in our study may be because SCORTEN was calculated only in patients with TEN and that the patients in our study group had more severe diseases.…”

Section: Discussionmentioning

confidence: 89%

“…[ 7 8 9 10 11 12 17 18 20 21 ] Mortality rates in TEN groups ranged between 16.7% and 71.4% [ Table 6 ]. [ 6 7 13 15 19 ] SJS/TEN mortality is known to be lower in children than in adults. [ 22 ] We think the factors that affect the variability of mortality rates in the literature are due to the nature of the disease; the studies can only be performed retrospectively; some studies are conducted in burns centers, whereas others not; variability in the numbers of patients; and variability in the distribution of pediatric and adult patients.…”

Section: Discussionmentioning

confidence: 99%

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Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis

Acar

Yoldas

Turk

et al. 2022

Indian Journal of Dermatology

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Background: Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute, life-threatening, severe drug reactions. Randomized studies on these diseases are difficult to perform. Aims and Objectives: The purpose of this study was to summarize the demographic and clinical characteristics of patients with SJS and TEN in a tertiary hospital in Turkey. Materials and Methods: We evaluated the records of 33 patients with SJS and TEN who were followed in our clinic or examined between January 2008 and June 2019, retrospectively. Age, sex, time of admission to hospital, causative drug, presence of concomitant disease, skin findings, mucosal involvement, the severity-of-illness score for TEN, the medication used, antibiotic use, transfer to intensive care, development of complications, and death or discharge status were noted. Results: Of the 33 patients, 11 (33.3%) had SJS, 3 (9.1%) had SJS/TEN overlap, and 19 (57.6%) had TEN. The majority (60.6%) of the patients were female. Nineteen (57.6%) patients had one, and 13 (39.4%) had more than one suspected drug exposure in their history. The most commonly suspected drugs were antibiotics. Twelve (36.4%) patients had intensive care unit hospitalization. Ten (30.3%) patients died. Conclusion: The demographic data of our study were consistent with the literature. Similar to the literature, antibiotics were the most common reaction-causing drugs. However, antiepileptic drugs, which were more frequently reported in other studies, were identified as suspicious in only one patient. We believe that our study will contribute to the determination of characteristics of this rare disease with real-life data.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis

Acar

Yoldas

Turk

et al. 2022

Indian Journal of Dermatology

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“…The treatment protocol consist of daily TPE with following IVIG infusion. [7] 76-year old woman was admitted to our unit with positive COVID 19 test (GeneFInder COVID-19 Plus RealAMP) with present RdRp, N, and E genes. Her medical history consists of blood hypertension and diabetes mellitus type 2.…”

Section: Sistémicomentioning

confidence: 99%

COVID-19 and TEN Treated With IVIG and Total Plasma Exchange: Simultaneous Systemic Treatment for Both Diseases

Krajewski¹,

Mlynska-Krajewska²,

Kaczyńska³

et al. 2021

J Investig Allergol Clin Immunol

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“…Although TPE has been has been successful in individual cases [26]. The frequency is 3 to 6 treatments daily or every other day, a chronic treatment of TPE with 1 treatment every two or four weeks for two or three months is possible, too.…”

Section: Avens Publishing Groupmentioning

confidence: 99%

Therapeutic Apheresis and/or Monoclonal Antibodies in Dermatological Diseases

2021

J Clin Investig Dermatol

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Inviting Innovations in autoantibody titers, antikeratinocyte cell surface antibodies, and anti-desmoglein-3 correlated with clinical response in a number of patients [2,[6][7][8][9]. The antiepidermal antibodies, which usually belong to the IgG category, can be easily eliminated with TPE [6,7].Bullous pemphigoid (BP) is another form of subepidermal blistering pemphigus; BP is rare. BP frequently involves a premonitory stage with pruritic urticarial erythema and eczematous lesions followed by the classical bullous stage with tense blisters, erosions, and crusts [8]. BP is a chronic dermatosis often associated with acute exacerbations, with the formation of bullae blisters usually on the inflamed skin, subepidermal blister formation, and antibodies against the epidermal basal membrane. Thus, BP can also occur in combination with other autoimmune disorders.The course of this pemphigus disorder is not as dramatic as other forms of the disease, with good response to high-potency corticosteroids, which are usually combined with dapsone, doxycycline, methotrexate, or azathioprine in usually dosages [3]. BP has an annual incidence of about 13-42 new cases per 1 million in central Europe and the United Kingdom [9,10]. Only a few cases have been treated with TPE up to noe [11]. After 3 to 5 treatments in one week, we could see if TPE or IA can decrease the antibody titer. In very low antibody titers, the frequency of the treatments can decrease, too. Because the pathogenic relevance of autoantibodies was clearly demonstrated in the majority of autoimmune bullous diseases, removal of autoantibodies, therefore, TPE is indicated. IA and rituximab have been establisheds additional therapeutic options [12]. D-Penicillamine induced pemphigus, steroid-resistant pemphigus, is a foliaceustype disease with high lethality and mortality rate, which can occur as a side effect in long-term penicillamine therapy, which is a particular indication for TPE [13]. Only case reports of D-penicillamine"-induced pemphigus" treated successfully with TA were reported in combination with immunosuppresion. IA is the most specific therapeutic option, in which only the pathogenic IgG is depleted in the patient's plasma. Three to 5 treatments of TPE or IA and immunosuppressive drugs in one or two weeks are necessary to an improvement of the disease. A combination of IA and rituximab showed rapid and long-lasting response of concomitant im-

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Toxic Epidermal Necrolysis Therapy with TPE and IVIG—10 Years of Experience of the Burns Treatment Center

Cited by 13 publications

References 38 publications

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis

COVID-19 and TEN Treated With IVIG and Total Plasma Exchange: Simultaneous Systemic Treatment for Both Diseases

Therapeutic Apheresis and/or Monoclonal Antibodies in Dermatological Diseases

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