Asthma Allergy Immunology

Asthma Allergy Immunology

2014, Vol 12, Num, 1     (Pages: 015-019)

Results of treatment in our patients with toxic epidermal necrolysis

Mehmet Halil ÇELİKSOY 1, Recep SANCAK 1, Ayhan SÖĞÜT 1, Şükrü Nail GÜNER 2, Şükrü PAKSU 3, Fadıl ÖZTÜRK 1,

1 Ondokuz Mayıs Üniversitesi Tıp Fakültesi, Çocuk Allerji ve İmmünoloji Anabilim Dalı, Samsun, Türkiye
2 Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, Çocuk Allerji ve İmmünoloji Anabilim Dalı, Konya, Türkiye
3 Ondokuz Mayıs Üniversitesi Tıp Fakültesi, Çocuk Yoğun Bakım Anabilim Dalı, Samsun, Türkiye

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Objective: Toxic epidermal necrolysis is a rare disease that has very high mortality and morbidity. Despite the high mortality rate of the disease, treatment is still controversial today. In this study, we discussed the treatment of patients who were treated and followed up due to the toxic epidermal necrolysis in our hospital.

Materials and Methods: This is a s tudy of children diagnosed as toxic epidermal necrolysis in our hospital between January 2011 and April 2013. We retrospectively analyzed response to the treatment.

Results: We followed five patients in this period with a clinical diagnosis of toxic epidermal necrolysis. The median age at diagnosis was nine years (min: 2, max: 15), and three of them were male. Toxic epidermal necrolysis occured in three of the patients after the use of anticonvulsants, in one of the patients after use of antibiotic and in one of the patients after the use of antihypertensive. Three of the patients were given combination of intravenous immunoglobulin (IVIG) (1 g/kg) with corticosteroid (1 mg/kg/day), two of the patients only were given IVIG (1 g/kg/day). In two patients, corticosteroid therapy was given for five days. In one case who was given corticosteroid therapy for seven days and with lesions more severe according to SCORTEN developed gram-negative sepsis in clinical follow. Especially patients developed toxic epidermal necrolysis after anticonvulsant showed more severe clinic and longer recovery period.

Conclusion: Improvement was observed in all patients. When only IVIG therapy compared to corticosteroid plus IVIG treatment, there were no superiority to each other.

Keywords : Toxic epidermal necrolysis, Lyell syndrome, drug hypersensitivity