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静脉注射免疫球蛋白及烧伤病房护理对中毒性表皮坏死松解症患儿疗效良好:病例报告及文献综述

IVIG and under Burn Unit Care Yield Favorable Outcomes in Pediatric Patients with Toxic Epidermal Necrolysis: A Case Report and Literature Review.

作者信息

Alzughayyar Tareq Z, Hamad Wasim Noureddin Ibrahim, Abuqweider Eman A S, Alqam Bilal Nabeel Mohammad, Abukhalaf Sadi A, Misk Rami A, Abunejma Fawzy M, Zalloum Jihad Samer, Saleh Mohanad, Abumunshar Ali A, Zatari Yousef I M

机构信息

Al-Quds University, Faculty of Medicine, Jerusalem, State of Palestine.

An-Najah National University, Faculty of Medicine & Health Sciences, Nablus, State of Palestine.

出版信息

Case Rep Dermatol Med. 2020 Jan 30;2020:6274053. doi: 10.1155/2020/6274053. eCollection 2020.

Abstract

Body reactions to drugs can manifest as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). TEN is the most severe form of cutaneous reactions with an incidence rate of 1-2 per million cases per year. Despite TEN being a critical and life-threatening condition, there is little to no evidence of clear management protocol. We reported a 5-year-old male child who presented with lamotrigine-induced TEN and was successfully treated with intravenous immune globulin (IVIG) with a burn unit care level, while TEN treatment with IVIG is an appropriate approach with predictable good outcomes, burn unit care is also effective in creating highly favorable effects. Upon reviewing the literature, several studies indicate that TEN patients treated with the combination of IVIG and burn unit care lead to decreased levels of morbidity and mortality than when treated with IVIG or burn unit care alone. Therefore, treatment involving both IVIG and burn unit care should be considered for TEN patients.

摘要

身体对药物的反应可表现为史蒂文斯-约翰逊综合征(SJS)和中毒性表皮坏死松解症(TEN)。TEN是最严重的皮肤反应形式,每年发病率为百万分之一至二。尽管TEN是一种危急且危及生命的病症,但几乎没有明确的管理方案的证据。我们报告了一名5岁男童,他出现了拉莫三嗪诱发的TEN,并在烧伤病房护理水平下成功接受了静脉注射免疫球蛋白(IVIG)治疗,虽然用IVIG治疗TEN是一种具有可预测良好结果的合适方法,但烧伤病房护理在产生高度有利效果方面也很有效。在查阅文献时,几项研究表明,与单独使用IVIG或烧伤病房护理相比,接受IVIG和烧伤病房护理联合治疗的TEN患者的发病率和死亡率水平有所降低。因此,对于TEN患者应考虑采用IVIG和烧伤病房护理相结合的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/730e/7013329/3f6304435c74/CRIDM2020-6274053.001.jpg

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