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Intravenous immunoglobulin use in patients with toxic epidermal necrolysis and stevens-johnson syndrome.
Am J Clin Dermatol. 2006;7(6):359-68.
Mittmann N, Chan B, Knowles S, Cosentino L, Shear N.
Division of Clinical Pharmacology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Intravenous
immunoglobulin (IVIg) has been proposed as a treatment for toxic
epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS). A
comprehensive search of the literature was conducted to examine the
efficacy and safety of IVIg in TEN and SJS patients.
Seventeen relevant
articles (14 TEN, 3 SJS) were identified. Only three of the TEN studies
and one of the SJS studies were prospective; retrospective studies were
the most common study design published. Information regarding disease
severity, IVIg use, response, and hospitalization were recorded and
cumulated. Aggregate level statistics were calculated. The average IVIg
doses used were 0.8 +/- 0.4 g/kg/day for a mean duration of 4.0 +/- 1.0
days in TEN patients and 0.8 +/- 0.2 g/kg/day for 3.4 +/- 1.0 days in
SJS patients. The clinical experience of IVIg use in TEN and SJS
patients was positive in most cases. However, more studies need to be
conducted to confirm the benefit of IVIg use in patients with TEN or
SJS.
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