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

Krajewski, Andrzej; Mlynska-Krajewska, Elzbieta; Kaczyńska, Katarzyna; Strużyna, Jerzy; Mazurek, Magdalena

doi:10.18176/jiaci.0692

Cited by 4 publications

(5 citation statements)

References 9 publications

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“… 2 Intravenous immunoglobulin (IVIG) can reduce the severity of COVID‐19 and TEN/SJS by inhibiting T‐cell activation, IL‐6 and TNF‐ɑ while neutralizing exogenous antigens. 7 , 22 , 24 Finally, plasmapheresis is a treatment method for COVID‐19 and TEN/SJS through the removal of serum cytokines and offending drugs/drug metabolites, highlighted by efficacy in patients refractory to systemic corticosteroid therapy. 22 , 24 However, others contend that plasmapheresis failed to demonstrate greater benefits relative to other supportive care strategies in a retrospective study.…”

Section: Discussionmentioning

confidence: 99%

“…Etanercept also demonstrated lower rates of gastrointestinal haemorrhage and higher efficacy in promoting re‐epithelialization compared to corticosteroids 2 . Intravenous immunoglobulin (IVIG) can reduce the severity of COVID‐19 and TEN/SJS by inhibiting T‐cell activation, IL‐6 and TNF‐ɑ while neutralizing exogenous antigens 7,22,24 . Finally, plasmapheresis is a treatment method for COVID‐19 and TEN/SJS through the removal of serum cytokines and offending drugs/drug metabolites, highlighted by efficacy in patients refractory to systemic corticosteroid therapy 22,24 .…”

Section: Discussionmentioning

confidence: 99%

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Toxic epidermal necrolysis and Stevens‐Johnson syndrome after COVID‐19 infection and vaccination

Zou

Daveluy

2022

Aust J Dermatology

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Stevens‐Johnson Syndrome (SJS) is a rare but severe skin reaction characterized by blistering and peeling of the skin and ulcerations of mucous membranes; toxic epidermal necrolysis (TEN) is a subset of SJS characterized by the involvement of >30% of the skin. Though previously associated with drugs and infections, discussions on the association between TEN/SJS and COVID‐19 have been limited. We present a review of TEN/SJS after COVID‐19 infection and vaccination. Literature searches were conducted on PubMed and Google Scholar from 2019 to 8/2022. Thirty‐eight articles were selected based on subject relevance, and references within selected articles were also screened for relevance. As of 8/2022, there have been 34 published cases of TEN, SJS, and SJS‐TEN overlap after COVID‐19 infection and vaccination, including 12 cases after vaccination and 22 cases after infection. Multiple authors hypothesize that virotopes or excipients in COVID‐19 vaccines can activate T‐cells or cytokines to induce TEN/SJS. Meanwhile, some hypothesize that COVID‐19 infection induces immune activation that can trigger TEN/SJS or increase susceptibility to drug‐induced TEN/SJS. Treatments for post‐infection and post‐vaccination TEN/SJS vary significantly. We recommend remaining vigilant for this rare and severe potential complication.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Toxic epidermal necrolysis and Stevens‐Johnson syndrome after COVID‐19 infection and vaccination

Zou

Daveluy

2022

Aust J Dermatology

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“… 22 In the literature, it has been reported that TNF‐α inhibitors and TPE are used in the treatment of a few cases of COVID‐19‐related TEN/SJS. 23 , 24 …”

Section: Discussionmentioning

confidence: 99%

“…22 In the literature, it has been reported that TNF-α inhibitors and TPE are used in the treatment of a few cases of COVID-19-related TEN/SJS. 23,24 It is known that the Influenza virus is involved in the etiology of classical SJS/TEN and these cases generally respond to treatment. 1 In our second case, the development of SJS/TEN is affiliated with Influenza A, which was positive in molecular analysis, and IVIG and steroid therapies were given.…”

Section: Discussionmentioning

confidence: 99%

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The role of treatment with plasma exchange therapy in two pediatric toxic epidermal necrolysis cases related to COVID‐19

Varol

Can

Şahin

et al. 2022

J of Clinical Apheresis

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Stevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life‐threatening mucocutaneous reactions characterized by necrosis and detachment of the epidermis. Drugs and bacterial or viral infections are the most common causes of SJS/TEN. Although cases of SJS/TEN have been reported after hydroxychloroquine, vaccine (mRNA [Biontech], and inactivated vaccine [Sinovac]) administration and during the clinical course of active Coronavirus disease 2019 (COVID‐19), limited data is indicating the COVID‐19 disease as a triggering factor. Also, there are no pediatric cases of SJS/TEN associated with COVID‐19 in the literature. Herein we reported two pediatric cases with a diagnosis of TEN related to COVID‐19. Therapeutic plasma exchange therapy was applied to both of our patients. Although there are a few adult cases in the literature, our article is the first pediatric case report about patients diagnosed with TEN related to COVID‐19 and successfully treated with plasma exchange.

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Dipyrone

2022

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

Cited by 4 publications

References 9 publications

Toxic epidermal necrolysis and Stevens‐Johnson syndrome after COVID‐19 infection and vaccination

Toxic epidermal necrolysis and Stevens‐Johnson syndrome after COVID‐19 infection and vaccination

The role of treatment with plasma exchange therapy in two pediatric toxic epidermal necrolysis cases related to COVID‐19

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