Retrospective review of Stevens-Johnson syndrome/toxic epidermal necrolysis treatment comparing intravenous immunoglobulin with cyclosporine - 16/10/14
, Monica A. Miliszewski, MD a, Sheena Sikora, MD b, Anthony Papp, MD, PhD b, Jan P. Dutz, MD a, cAbstract |
Background |
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are mucocutaneous reactions, typically to medications, that are associated with a high patient mortality. Controversy exists over which systemic treatments decrease mortality associated with SJS/TEN.
Objective |
In this study we sought to determine whether intravenous immunoglobulin (IVIg) or cyclosporine use for SJS/TEN results in better patient outcomes.
Methods |
We undertook a retrospective chart review of 71 patients admitted between 2001 and 2011 for SJS/TEN at a tertiary care center of which 64 cases were included in the data analysis. Predicted severity-of-illness score for TEN mortality was compared with actual mortality for patients treated with either cyclosporine or IVIg.
Results |
Our cohort demonstrated a relative mortality benefit to the use of cyclosporine in the treatment of SJS/TEN with a standardized mortality ratio of 0.43, over the use of IVIg with a standardized mortality ratio of 1.43.
Limitations |
This is single-center retrospective study.
Conclusions |
The use of cyclosporine over IVIg may offer a greater mortality benefit in the treatment of SJS/TEN.
Le texte complet de cet article est disponible en PDF.Key words : cyclosporine, intravenous immunoglobulin, Stevens-Johnson syndrome, toxic epidermal necrolysis
Abbreviations used : BSA, IVIg, SCORTEN, SJS, SMR, TEN
Plan
| Funding sources: None. |
|
| Conflicts of interest: None declared. |
Vol 71 - N° 5
P. 941-947 - novembre 2014 Retour au numéro
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