Treatment of Toxic Epidermal Necrolysis

Stevens-Johnson syndrome and toxic epidermal necrolysis: a review of treatment options

“…Indeed, cited total doses range from 400 mg/kg to 4 g/kg. Also, while the use of scoring systems such as SCORTEN have certainly helped to standardize comparisons among patient populations, all of the aforementioned studies have been of such a small patient size, as to limit statistical significance unless results are pooled together (75). Thus, the use of IVIG for the treatment of TEN is a contentious issue and one that warrants further study and review in a more systematic framework.…”

Successful intravenous human immunoglobulin treatment of drug‐induced Stevens‐Johnson syndrome in a dog

“…One recent study reported that inclusion of ivHIG in the treatment regimen reduced mortality in human TEN by 83 per cent (Trent and Kirsner 2003) and in another survival rates improved from 75 per cent to 88 per cent (Prins and others 2003). Multiple studies have demonstrated that ivHIG therapy is beneficial in EM/TEN others 1998, Wolff andTappeiner 2003), although one study reported a 33 per cent increase in mortality in elderly patients with SJS/TEN (Bachot and others 2003). These conflicting findings may reflect the uncertainty surrounding the pathogenesis of SJS/TEN and the fact that patients with multiple organ failure and septic shock are more difficult to manage, especially in the elderly or where there is pre-existing disease (Wolff and Tappeiner 2003).…”

“…Multiple studies have demonstrated that ivHIG therapy is beneficial in EM/TEN others 1998, Wolff andTappeiner 2003), although one study reported a 33 per cent increase in mortality in elderly patients with SJS/TEN (Bachot and others 2003). These conflicting findings may reflect the uncertainty surrounding the pathogenesis of SJS/TEN and the fact that patients with multiple organ failure and septic shock are more difficult to manage, especially in the elderly or where there is pre-existing disease (Wolff and Tappeiner 2003). Treatment with ivHIG has also been of benefit in pemphigus foliaceus, pemphigus vulgaris, bullous pemphigoid, mucous membrane (or cicatricial) pemphigoid and epidermolysis bullosa acquista (Ahmed and Dahl 2003).…”

“…A purified mixture of immunoglobulins, mostly IgG, of varying antigen specificity and affinity with trace amounts of cytokines and chemokines makes up ivHIG (Scott Moncrieff andReagan 1997, Wolff andTappeiner 2003). It should contain at least 90 per cent intact, biologically active IgG and be free from aggregates, kinins, plasmin, kallikrein activators and infectious agents (Scott Moncrieff and Reagan 1997).…”

Intravenous immunoglobulin in dermatology

“…[16] Most adverse reactions will disappear if the infusion is temporarily discontinued or if the infusion rate is lowered. Reactions such as headache, back pain, chills, flushing, fever, hypertension, myalgia, nausea and vomiting appear to be related to infusion rate rather than the dose.…”