To confirm that corticosteroids are beneficial in the treatment of Stevens-Johnson syndrome (SJS), 15 patients with the syndrome were evaluated by the same group of physicians over 2 years. All pat ients had cutaneous and most had mucosal lesions. Patients were treated with corticosteroids rangingfrom prednisone 40 mg daily to methylprednisolone 750 mg daily. The same group of physicians participated in the management of these patients until recovery. No deaths occurred among the 15 patients. Recovery was complete in all cases, and there was no residual skin, mucosal, or visceral damage except for minimal scarring in one patient. In some cases, reversal of disease after onset of corticosteroid therapy was sufficiently dramatic to demonstrate a benefit. The use of corticosteroids in the treatment of SJS remains controversial. We conclude that corticosteroids are beneficial in treatment of the syndrome. They may be lifesaving in some patients and should be the standard of therapy. SJS should be considered to be erythema multiforme with either bullous lesions or visceral involvement or both. (AllergyProc. 13, 2:89-95, 1992)
We have studied the immune response of chemical workers who are exposed to trimellitic anhydride (TMA), a biologically reactive anhydride used in the manufacture of plastics. Serum antibody activity to TMA haptenized human serum albumin (TM-HSA) was measured in workers with three clinically defined respiratory tract syndromes; asthma-rhinitis, a late respiratory systemic syndrome (LRSS), and an irritant syndrome. IgE antibody binding of 125I TM-HSA was quantitated by polystyrene tube radioimmunoassay and total serum antibody binding of 125I-TM-HSA by an ammonium sulfate technique. IgE antibody activity ranged from 2 to 55 ng TM-HSA bound per milliliter and was associated with the asthma-rhinitis syndrome. Total serum antibody activity ranged from 0.4 to 56 μg TM-HSA bound per milliliter and was associated with either the asthma-rhinitis syndrome or LRSS. Antibody specificity for TM-HSA was determined by inhibition studies using sodium trimellitate (NaTM) and a variety of TM substituted carriers. The hapten, NaTM, was an extremely poor inhibitor of IgE or total antibody binding of TM-HSA. The other TMA haptenized carriers were either noninhibitory or had to be added in milligram quantities to effect any inhibition as contrasted with complete inhibition achieved by microgram quantities of TM-HSA. These specificity studies indicate that the inhalation of TMA results in an antibody response with specificity for unique new antigenic determinants (NAD) which arise from the coupling of TMA with autologous respiratory tract proteins.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.