PMID- 23839186
OWN - NLM
STAT- MEDLINE
DCOM- 20140210
LR  - 20130710
IS  - 1545-9616 (Print)
IS  - 1545-9616 (Linking)
VI  - 12
IP  - 6
DP  - 2013 Jun 1
TI  - Early treatment with nonsucrose intravenous immunoglobulin in a burn unit reduces 
      toxic epidermal necrolysis mortality.
PG  - 679-84
AB  - BACKGROUND: Intravenous immunoglobulin (IVIG) can be used to treat potentially 
      deadly toxic epidermal necrolysis (TEN), milder Stevens Johnson Syndrome (SJS) 
      and intermediate TEN/SJS overlap. Some formularies now deny IVIG for TEN based on 
      the EuroSCAR TEN/SJS study that reported a nonsignificant trend toward increased 
      mortality in 75 IVIG-treated TEN/SJS patients; of note the IVIG patients had more 
      TEN and less SJS than patients in other treatment arms. EuroSCAR data on 
      mortality among the 25 IVIG-treated TEN patients, use of nonsucrose IVIG, and 
      admission to specialized settings such as burn units was not disclosed. The 
      impact of treatment setting (specialized unit vs general ward) on IVIG efficacy 
      has not previously been studied. OBJECTIVE: To evaluate efficacy of treating TEN 
      with early nonsucrose IVIG in a burn unit. METHODS: Data were retrospectively 
      collected from 13 IVIG-treated TEN patients admitted to a burn unit over a 6-year 
      period. RESULTS: We report 0% mortality among 13 IVIG-treated TEN patients. 
      Mortality was significantly lower than predicted by SCORTEN. Mortality was also 
      significantly lower than the EuroSCAR groups receiving IVIG (P<.005), supportive 
      care (P<.018), and corticosteroids only (P<.046). CONCLUSION: TEN patients may 
      benefit from early nonsucrose IVIG administered in burn units or other 
      specialized settings.
FAU - Aires, Daniel J
AU  - Aires DJ
AD  - Division of Dermatology, Department of Internal Medicine, University of Kansas 
      Medical Center, Kansas City, KS, USA. daires@kumc.edu
FAU - Fraga, Garth
AU  - Fraga G
FAU - Korentager, Richard
AU  - Korentager R
FAU - Richie, Coleman P
AU  - Richie CP
FAU - Aggarwal, Smita
AU  - Aggarwal S
FAU - Wick, Jo
AU  - Wick J
FAU - Liu, Deede Y
AU  - Liu DY
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Drugs Dermatol
JT  - Journal of drugs in dermatology : JDD
JID - 101160020
RN  - 0 (Immunoglobulins, Intravenous)
RN  - 0 (Immunologic Factors)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Burn Units
MH  - Child
MH  - Female
MH  - Humans
MH  - Immunoglobulins, Intravenous/administration & dosage/chemistry/*therapeutic use
MH  - Immunologic Factors/administration & dosage/chemistry/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Stevens-Johnson Syndrome/*drug therapy/mortality/physiopathology
MH  - Time Factors
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2013/07/11 06:00
MHDA- 2014/02/11 06:00
CRDT- 2013/07/11 06:00
PHST- 2013/07/11 06:00 [entrez]
PHST- 2013/07/11 06:00 [pubmed]
PHST- 2014/02/11 06:00 [medline]
AID - S1545961613P0679X [pii]
PST - ppublish
SO  - J Drugs Dermatol. 2013 Jun 1;12(6):679-84.