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High-dose intravenous immunoglobulin for severe drug reactions: efficacy in toxic epidermal necrolysis

Authors :
Campione, E
Marulli, G
Carrozzo, Am
Chimenti, Ms
Costanzo, A
Bianchi, L
Source :
Acta dermato-venereologica. 83(6)
Publication Year :
2003

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.

Details

ISSN :
00015555
Volume :
83
Issue :
6
Database :
OpenAIRE
Journal :
Acta dermato-venereologica
Accession number :
edsair.pmid.dedup....155d348dec94a94c861238eaa4d85289