Treatment of toxic epidermal necrolysis with cyclosporin A
| Autor: | José M. Arévalo, José A. Lorente, José Jiménez-reyes, Carlos González-Herrada |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Cyclophosphamide Critical Care medicine.medical_treatment Critical Care and Intensive Care Medicine Gastroenterology Methylprednisolone Internal medicine Intensive care Cyclosporin a medicine Humans Aged Body surface area Aged 80 and over Chemotherapy Leukopenia business.industry Middle Aged medicine.disease Toxic epidermal necrolysis Surgery Treatment Outcome Stevens-Johnson Syndrome Cyclosporine Drug Therapy Combination Female medicine.symptom business Burns Immunosuppressive Agents medicine.drug |
| Zdroj: | The Journal of trauma. 48(3) |
| ISSN: | 0022-5282 |
| Popis: | Background: Toxic epidermal necrolysis (TEN) is a severe skin disorder characterized by separation of the dermal-epidermal junction, as is observed in second-degree superficial burns. It has been proposed that immunosuppressive treatment may improve prognosis of patients with TEN. Methods: We report here a case series of patients with TEN treated with cyclosporin A (CSA) without other concomitant immunosuppressive agent These patients (n = 11) were consecutively admitted to our Intensive Care Burn Unit because of severe TEN, involving a large body surface area (83 ±17% [mean ± SD], median, 90%; range, 35-96%) and were treated with CSA 3 mg/kg per day enterally every 12 hours. We compared the series of patients treated with CSA with a historical series of patients admitted to our Intensive Care Burn Unit before CSA was introduced as part of the treatment protocol. These patients (n = 6) were treated with cyclophosphamide (150 mg i.v. every 12 hours) and different doses of corticosteroids (≥1 mg/kg per day of 6-methyl-prednisolone). Both groups of patients were similar in regard to age, delay from onset of disease to Intensive Care Burn Unit admission, and body surface area involved. Results: Time from the onset of skin signs to arrest of the disease progression (1.4 ± 0.3 days, vs. 3.6 ± 1.5 days) and to complete reepithelialization (12.0 ± 3.6 days, vs. 17.6 ± 3.1 days) was significantly shorter in patients treated with CSA compared with those treated with cyclophosphamide and corticosteroids (p = 0.0002, and p = 0.0058, respectively). Significantly fewer patients in the CSA group had ≥4 organs failing (2 of 11 vs. 3 of 6, respectively, p = 0.029), had severe leukopenia ( |
| Databáze: | OpenAIRE |
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