Mortality and risk factors on admission in toxic epidermal necrolysis: A cohort study of 59 patients

Watanabe, Tomoya; Go, Hirofumi; Saigusa, Yusuke; Takamura, Naoko; Watanabe, Yûko; Yamane, Yumiko; Totsuka, Michiru; Ishikawa, Hideyuki; Nakamura, Kazuko; Matsukura, Setsuko; Kambara, Takeshi; Takaki, Shunsuke; Yamaguchi, Yukie; Aihara, Michiko

doi:10.1016/j.alit.2020.11.004

Cited by 20 publications

(28 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Bronchial necrosis and respiratory failure worsen the outcome as well [7]. Watanabe recognized late initiation of treatment at the specialty hospital as one of the mortality prognostic tools [24]. There is some evidence, however, that SCORTEN assessment can remain a valuable prognostic tool within the rst 5 days after admission [21].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of SCORTEN in predicting mortality

Strużyna

Surowiecka

Korzeniowski

et al. 2022

Preprint

View full text Add to dashboard Cite

BackgroundTEN patients require multi-directional and multi-disciplinary treatment. In most cases, they are hospitalised at intensive care units and require multi-directional, burn-complication preventive care. Choosing the most appropriate treatment option might be troublesome even when predicting scores are used. SCORTEN is the most renowned prognostic score for TEN patients, however, there are some data indicating that the accuracy of this test may be limited. The credibility of not just the predicted mortality risk, but also componential laboratory results and clinical features subject to debate. The aim of this study was to evaluate the efficacy and credibility of SCORTEN in clinical practice, on proprietary material. Methods: A retrospective analysis of 35 patients with diagnosed in histopathology TEN was performed. The inclusion criteria were as follows: day of submission before 5th day from the onset of the symptoms, full protocol of plasmaphereses and IVIGs according to our scheme.Results:The sensitivity of SCORTEN for the analysed cohort was 100%, with a specificity of 24%. The estimated death was 41,9%, while the actual death rates were 12,5%. Our protocol improved the survival, OR=26,57, RR=6,34, p=0,022. Decrease in mortality was caused by a combined treatment protocol we use- plasmaphereses with IVIGs. No independent risk factor was significant in death evaluation. Conclusions:Our data suggest that the scoring system for predicting death among TEN patients are reliable when they are high. New prognostic factors should be found to improve the evaluation of patients with low SCORTEN.

show abstract

Section: Discussionmentioning

confidence: 99%

Accuracy of SCORTEN in predicting mortality

Strużyna

Surowiecka

Korzeniowski

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…18 Acetaminophen is believed to be a safe analgesic and antipyretic agent and is widely used as a prescription drug or over-the-counter medicine in all age groups. It has been reported that antipyretic anti-inflammatory agents, including acetaminophen, are one of the causative drugs of cutaneous adverse drug reactions 6,17 while analysis from the French pharmacovigilance database has shown that there is no SJS/TEN risk related to the use of acetaminophen. 19 Nevertheless, acetaminophen was the offending drug in two cases of SJS-related liver transplantation (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…4 Indeed, several studies on the risk factors of SJS/TEN report that liver dysfunction did not affect the mortality rate of SJS/TEN. [5][6][7] However, very few cases of severe liver dysfunction require liver transplantation. We report the first case to be published on a…”

mentioning

confidence: 99%

A pediatric case of Stevens‐Johnson syndrome with acute liver failure, resulting in liver transplantation

Totsuka

Watanabe

Takamura

et al. 2021

The Journal of Dermatology

Self Cite

View full text Add to dashboard Cite

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening cutaneous adverse reactions characterized by widespread epidermal necrolysis of the skin and mucosa. Skin involvement is greater in TEN, with more than 30% of total body surface area involvement. 1 SJS/TEN is occasionally complicated by various organ disorders, such as gastrointestinal disorders, respiratory disorders, liver dysfunction, and renal dysfunction, leading to irreversible damage and death in some patients. 2,3 Liver dysfunction is a relatively common complication in SJS/ TEN; however, this complication usually improves spontaneously or with SJS/TEN treatment and is rarely a serious clinical problem. 4 Indeed, several studies on the risk factors of SJS/TEN report that liver dysfunction did not affect the mortality rate of SJS/TEN. [5][6][7] However, very few cases of severe liver dysfunction require liver transplantation. We report the first case to be published on a

show abstract

“…Many but likely not all idiosyncratic ADRs are immunologically mediated and can affect virtually any tissue, either in isolation or in combination with systemic effects (Phillips 2016 ). Idiosyncratic ADRs are more often severe or life-threatening with specific manifestations, such as Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) resulting in mortality rates up to 13–60% (Schulz et al 2000 ; Watanabe et al 2021 ). The human leukocyte antigen ( HLA ) gene family encodes the major histocompatibility complex (MHC), which regulates T-cell mediated immunity.…”

Section: Pharmacogenetically Important Hla Allelesmentioning

confidence: 99%

Population pharmacogenomics: an update on ethnogeographic differences and opportunities for precision public health

Zhou

Lauschke

2021

Hum Genet

View full text Add to dashboard Cite

Both safety and efficacy of medical treatment can vary depending on the ethnogeographic background of the patient. One of the reasons underlying this variability is differences in pharmacogenetic polymorphisms in genes involved in drug disposition, as well as in drug targets. Knowledge and appreciation of these differences is thus essential to optimize population-stratified care. Here, we provide an extensive updated analysis of population pharmacogenomics in ten pharmacokinetic genes (CYP2D6, CYP2C19, DPYD, TPMT, NUDT15 and SLC22A1), drug targets (CFTR) and genes involved in drug hypersensitivity (HLA-A, HLA-B) or drug-induced acute hemolytic anemia (G6PD). Combined, polymorphisms in the analyzed genes affect the pharmacology, efficacy or safety of 141 different drugs and therapeutic regimens. The data reveal pronounced differences in the genetic landscape, complexity and variant frequencies between ethnogeographic groups. Reduced function alleles of CYP2D6, SLC22A1 and CFTR were most prevalent in individuals of European descent, whereas DPYD and TPMT deficiencies were most common in Sub-Saharan Africa. Oceanian populations showed the highest frequencies of CYP2C19 loss-of-function alleles while their inferred CYP2D6 activity was among the highest worldwide. Frequencies of HLA-B*15:02 and HLA-B*58:01 were highest across Asia, which has important implications for the risk of severe cutaneous adverse reactions upon treatment with carbamazepine and allopurinol. G6PD deficiencies were most frequent in Africa, the Middle East and Southeast Asia with pronounced differences in variant composition. These variability data provide an important resource to inform cost-effectiveness modeling and guide population-specific genotyping strategies with the goal of optimizing the implementation of precision public health.

show abstract

Mortality and risk factors on admission in toxic epidermal necrolysis: A cohort study of 59 patients

Cited by 20 publications

References 27 publications

Accuracy of SCORTEN in predicting mortality

Accuracy of SCORTEN in predicting mortality

A pediatric case of Stevens‐Johnson syndrome with acute liver failure, resulting in liver transplantation

Population pharmacogenomics: an update on ethnogeographic differences and opportunities for precision public health

Contact Info

Product

Resources

About