2012
DOI: 10.1001/archderm.148.4.dlt120002-c
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Poor Benefit/Risk Balance of Intravenous Immunoglobulins in DRESS

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Cited by 94 publications
(12 citation statements)
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References 4 publications
(7 reference statements)
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“…Similar to SJS/TEN, the use of systemic immunomodulatory treatments such as high-dose intravenous immunoglobulin have been used in DRESS with case reports of success (119), Caution should be exerted given the lack of evidence supporting this practice and at least one intravenous immunoglobulin DRESS treatment study that was terminated early because of lack of benefit, need for rescue corticosteroid treatment, and severe ADRs in 5/6 patients. This included one patient with pulmonary embolism at day 9 which is a described ADR associated with intravenous immunoglobulin, particularly in the setting of underlying autoimmune disease(120, 121) . In cases of internal organ failure, organ specific treatment and supportive care should be initiated.…”
Section: Managementmentioning
confidence: 99%
“…Similar to SJS/TEN, the use of systemic immunomodulatory treatments such as high-dose intravenous immunoglobulin have been used in DRESS with case reports of success (119), Caution should be exerted given the lack of evidence supporting this practice and at least one intravenous immunoglobulin DRESS treatment study that was terminated early because of lack of benefit, need for rescue corticosteroid treatment, and severe ADRs in 5/6 patients. This included one patient with pulmonary embolism at day 9 which is a described ADR associated with intravenous immunoglobulin, particularly in the setting of underlying autoimmune disease(120, 121) . In cases of internal organ failure, organ specific treatment and supportive care should be initiated.…”
Section: Managementmentioning
confidence: 99%
“…The implementation of additional treatment including intravenous immunoglobulins, corticosteroids and antivirals is generally based on experience rather than proven benefits drawn from well-designed clinical trials [1113]. Administration of corticosteroids in severe pulmonary involvement seems to be reasonable according to results from some studies [13, 14].…”
Section: Discussionmentioning
confidence: 99%
“…Full recovery will generally be obtained after weeks, even with an early and optimal management [ 5 ]. Intravenous immunoglobulins are no longer recommended due to their frequent secondary effects and lack of benefit compared to corticotherapy [ 19 ]. A granulopoietic stimulant (G-CSF) can be discussed.…”
Section: Discussionmentioning
confidence: 99%