Department of Dermatology, Changi General Hospital, Singapore.
Int J Dermatol. 2011 Dec;50(12):1570-8. doi: 10.1111/j.1365-4632.2011.05007.x.
Derangements in blood cell counts have been described in patients with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) but are not well characterized. We aim to describe the relationship between our patients' hematological results and the evolution of disease and hypothesize on the possible roles of granulocyte-colony-stimulating factor (G-CSF) in the management of these conditions.
Clinical records of our patients with SJS and TEN from January 2005 to 2010 were analyzed.
Anemia and lymphopenia were most commonly seen, while thrombocytopenia was uncommon. Leukopenia and neutropenia were seen in patients with more severe disease, and the trend of leukopenia and neutropenia followed the evolution of disease. Two patients received G-CSF for febrile neutropenia and had a rapid recovery of their neutrophil counts as well as a shorter time to re-epithelialization.
Our patients tended to have leukopenia and neutropenia that followed a predictable trend of decline and subsequent improvement depending on the stage of disease. This may be of pathogenic significance, and G-CSF may be used in these cases to manage febrile neutropenia and aid re-epithelialization. Further basic science research is required to prove our hypotheses.
史蒂文斯-约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）患者的血细胞计数出现异常，但尚未得到充分描述。我们旨在描述患者的血液学结果与疾病演变之间的关系，并推测粒细胞集落刺激因子（G-CSF）在这些疾病治疗中的可能作用。
分析了 2005 年 1 月至 2010 年期间我们收治的 SJS 和 TEN 患者的临床记录。
贫血和淋巴细胞减少最常见，而血小板减少不常见。白细胞减少和中性粒细胞减少见于病情较重的患者，白细胞减少和中性粒细胞减少的趋势与疾病的演变一致。两名患者因发热性中性粒细胞减少症接受了 G-CSF 治疗，中性粒细胞计数迅速恢复，上皮再形成时间也缩短。
我们的患者往往存在白细胞减少和中性粒细胞减少，这些异常随疾病阶段呈可预测的下降和随后的改善趋势。这可能具有发病意义，在这些情况下，G-CSF 可用于治疗发热性中性粒细胞减少症并有助于上皮再形成。需要进一步的基础科学研究来验证我们的假设。
