Successful management of a patient with toxic epidermal necrolysis by high dose intravenous immunoglobulin Toksik epidermal nekrolizisli bir hastanın yüksek doz intravenöz immünglobulin ile başarılı tedavisi
نویسندگان
چکیده
Toksik epidermal nekrolizis (TEN) sıklıkla ilaç kullanımı sonucu gelişen, akut başlangıçlı, çok hızlı ilerleyen, epidermis nekrozu ile karakterize bir hastalıktır. Şiddetli seyreden olgularda mortalite oranı %20-60 arasında değişir. Kesin tedavisi olmamasına rağmen intravenöz immünglobulin (İVİG) tedavisinin etkili olduğunu belirten yayınlar mevcuttur. Bu çalışmada; ibuprofen, metronidazol, klaritromisin ve prokain penisilin kullandıktan üç gün sonra deri döküntüleri başlayan ve %50 oranında ikinci derecede yanık düzeyinde lezyonlar ile TEN tablosu gelişen 9 yaşında erkek hasta sunulmuştur. Hastaya verilen yüksek doz İVİG tedavisi ile düzelme sağlandı. Bu olgu TEN tedavisinde etkinliği tartışmalı olan İVİG tedavisine olumlu yanıt alınabileceğine bir örnektir.
منابع مشابه
Causes and treatments of Stevens - Johnson syndrome and toxic epidermal necrolysis in Iranian patients
Aims: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious severe cutaneous adverse reactions with high mortality and morbidity induced by medications. In this cross sectional study, we investigated, suspected drugs, and potential treatments of SJS/TEN. Methods: A cross- sectional descriptive study was conducted on 60 patients admitted with a diagnosis of Stevens-Jo...
متن کاملCombination of Infliximab and High-Dose Intravenous Immunoglobulin for Toxic Epidermal Necrolysis: Successful Treatment of an Elderly Patient
Toxic epidermal necrolysis (TEN) is a rare, severe cutaneous adverse drug reaction with average mortality 25-35%, especially among elderly multimorbid patients. Established therapeutic guidelines do not exist and controversies underlie many of the presently suggested treatment regimens. Herein we present the use of the recently described combination scheme of methylprednisolone (500 mg methylpr...
متن کاملAntibiotic-induced Toxic Epidermal Necrolysis - A Case Report.
Toxic epidermal necrolysis (TEN) is severe cutaneous hypersensitivity reaction characterized by necrosis of the epidermis and detachment of the epidermis and dermis that usually occurs as an idiosyncratic reaction to certain drugs. We report the case of a patient admitted to our Intensive Care Unit after an above-the-knee amputation who developed toxic epidermal necrolysis, possibly resulting f...
متن کاملReactivation of Cytomegalovirus in a Patient with Stevens-Johnson Syndrome-Toxic Epidermal Necrolysis
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe adverse cutaneous reactions to drugs. We describe the case of a 19 year old patient with SJS/TEN overlap syndrome, who developed severe interstitial pneumonia after she had received antiepileptic drugs. A cytomegalovirus infection was diagnosed by Real Time Polymerase Chain Reaction (RT-PCR) detection on Bronchoalveo...
متن کاملSevere cutaneous adverse reactions to drugs.
PURPOSE OF REVIEW This paper updates the treatment of Stevens-Johnson syndrome and toxic epidermal necrolysis supported by relevant views about the pathogenesis. RECENT FINDINGS Building on the thesis that Stevens-Johnson syndrome and toxic epidermal necrolysis are due to dermal cell apoptosis, molecular pathways that may lead to this have been proposed. Intravenous immunoglobulin is postulat...
متن کامل