1. Disseminated intravascular coagulation in Stevens-Johnson syndrome and toxic epidermal necrolysis
- Author
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Yen-Chang Hsiao, Ya-Chung Tian, Kuo-Chin Kao, Jui-Yung Yang, Ya-Ching Chang, Shih-Yi Yang, Ting-Shu Wu, Han-Chung Hu, Hsin-Chun Ho, Ren-Feng Liu, Chung Wen-Hung, Cheng-Lung Ku, Pin-Hsuan Chiang, Shuen-Iu Hung, Chun-Wei Lu, Jing-Yi Lin, Tsun-Hao Hsu, Shiow-Shuh Chuang, Chee-Jen Chang, David Hui-Kang Ma, Ming-Ying Wu, Chao-Wei Hsu, Chun-Bing Chen, Min-Hui Chi, Chi-Yuan Cheng, Rosaline Chung-Yee Hui, Chi-Hua Chen, Shin-Yi Chen, Yu-Jr Lin, Chi-Hui Wang, Wei-Ti Chen, Wang Chuang-Wei, Shu-Ying Chang, and Yang Yu-Wei Lin
- Subjects
Adult ,Male ,medicine.medical_specialty ,Gastrointestinal bleeding ,Bacteremia ,Dermatology ,Kaplan-Meier Estimate ,Procalcitonin ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Coagulopathy ,Humans ,Renal Insufficiency ,Aged ,Disseminated intravascular coagulation ,Aged, 80 and over ,business.industry ,Disseminated Intravascular Coagulation ,Middle Aged ,medicine.disease ,Toxic epidermal necrolysis ,Survival Rate ,stomatognathic diseases ,Respiratory failure ,030220 oncology & carcinogenesis ,Stevens-Johnson Syndrome ,Female ,Complication ,business ,Gastrointestinal Hemorrhage ,Respiratory Insufficiency ,Liver Failure - Abstract
Background Patients with Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) have high mortality rates. Disseminated intravascular coagulation has been reported in SJS/TEN patients. The influence of this lethal complication in patients with SJS/TEN is not well known. Objective This study aimed to investigate the risk and outcomes of disseminated intravascular coagulation in patients with SJS/TEN. Methods We analyzed the disseminated intravascular coagulation profiles of patients receiving a diagnosis of SJS/TEN between 2010 and 2019. Results We analyzed 150 patients with SJS/TEN (75 with SJS, 22 with overlapping SJS/TEN, and 53 with TEN) and their complete disseminated intravascular coagulation profiles. Disseminated intravascular coagulation was diagnosed in 32 patients (21.3%), primarily those with TEN. It was significantly associated with systemic complications, including gastrointestinal bleeding, respiratory failure, renal failure, liver failure, infection, and bacteremia. Additionally, SJS/TEN patients with disseminated intravascular coagulation had elevated procalcitonin levels. Among patients with SJS/TEN, disseminated intravascular coagulation was associated with a greater than 10-fold increase in mortality (78.1% vs 7%). Limitations The study limitations include small sample size and a single hospital system. Conclusion Disseminated intravascular coagulation is a potential complication of SJS/TEN and associated with higher mortality. Early recognition and appropriate management of this critical complication are important for patients with SJS/TEN.
- Published
- 2020