High-dose intravenous immunoglobulin has been proposed as an alternative treatment for several immuno-mediated inflammatory skin diseases, usually at a dosage of 1-2 g/kg. We describe the treatment of 10 patients affected by toxic epidermal necrolysis using 400 mg/kg per day on 5 consecutive days - a schedule that is lower than previously reported schedules. According to the SCORTEN, the earlier predicted mortality rate was 35%. After high-dose intravenous immunoglobulin therapy, a mortality rate of 10% and a survival rate of 90% were reached. In particular, nine patients showed a dramatic improvement already after one course of infusion started at an early stage of the disease. It is our experience, and that of others, that high-dose intravenous immunoglobulin can be considered the drug of first choice for toxic epidermal necrolysis, one of the most severe life-threatening dermatological conditions, and a valid alternative therapy for different long-standing chronic dermatological diseases. This therapy can also be effective in avoiding high steroid dosages and consequently steroid-related or immunosuppressive-related side effects. It is therefore reasonable to propose high-dose intravenous immunoglobulin treatment as a valuable therapeutic tool for dermatologists.

Campione, E., Marulli, G., Carrozzo, A.m., Chimenti, M.s., Costanzo, A., Bianchi, L. (2003). High-dose Intravenous Immunoglobulin for Severe Drug Reactions: Efficacy in Toxic Epidermal Necrolysis. ACTA DERMATO-VENEREOLOGICA, 83(6), 430-432 [10.1080/00015550310005852].

High-dose Intravenous Immunoglobulin for Severe Drug Reactions: Efficacy in Toxic Epidermal Necrolysis

CAMPIONE, ELENA;CARROZZO, ANNA MARIA;CHIMENTI, MARIA SOLE;COSTANZO, ANTONIO;BIANCHI, LUCA
2003-01-01

Abstract

High-dose intravenous immunoglobulin has been proposed as an alternative treatment for several immuno-mediated inflammatory skin diseases, usually at a dosage of 1-2 g/kg. We describe the treatment of 10 patients affected by toxic epidermal necrolysis using 400 mg/kg per day on 5 consecutive days - a schedule that is lower than previously reported schedules. According to the SCORTEN, the earlier predicted mortality rate was 35%. After high-dose intravenous immunoglobulin therapy, a mortality rate of 10% and a survival rate of 90% were reached. In particular, nine patients showed a dramatic improvement already after one course of infusion started at an early stage of the disease. It is our experience, and that of others, that high-dose intravenous immunoglobulin can be considered the drug of first choice for toxic epidermal necrolysis, one of the most severe life-threatening dermatological conditions, and a valid alternative therapy for different long-standing chronic dermatological diseases. This therapy can also be effective in avoiding high steroid dosages and consequently steroid-related or immunosuppressive-related side effects. It is therefore reasonable to propose high-dose intravenous immunoglobulin treatment as a valuable therapeutic tool for dermatologists.
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/16 - Reumatologia
Settore MED/35 - Malattie Cutanee e Veneree
English
High-dose intravenous immunoglobulin; Toxic epidermal necrolysis; Adult; Aged; Aged, 80 and over; Child; Dose-Response Relationship, Drug; Drug Hypersensitivity; Female; Follow-Up Studies; Humans; Immunoglobulins, Intravenous; Male; Middle Aged; Prospective Studies; Risk Assessment; Severity of Illness Index; Stevens-Johnson Syndrome; Treatment Outcome; Drug-Related Side Effects and Adverse Reactions; 2708
Campione, E., Marulli, G., Carrozzo, A.m., Chimenti, M.s., Costanzo, A., Bianchi, L. (2003). High-dose Intravenous Immunoglobulin for Severe Drug Reactions: Efficacy in Toxic Epidermal Necrolysis. ACTA DERMATO-VENEREOLOGICA, 83(6), 430-432 [10.1080/00015550310005852].
Campione, E; Marulli, G; Carrozzo, Am; Chimenti, Ms; Costanzo, A; Bianchi, L
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/119629
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