Cornea and Refractive Surgery Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Excellence Center of Cornea and Limbal Stem Cell Transplantation, Department of Ophthalmology, 1873 King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, 10330, Thailand.
Sci Rep. 2021 Oct 12;11(1):20275. doi: 10.1038/s41598-021-99370-1.
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions with high mortality rates. Its sequelae, such as blindness, persist even after recovery. Patients with SJS/TEN should be accurately diagnosed and receive appropriate treatment as soon as possible. Therefore, identifying the factors for severity prediction is necessary. We aimed to clarify the clinical parameters and biological markers that can predict acute severe ocular complications (SOCs) in SJS/TEN. This retrospective cross-sectional study enrolled 47 patients with SJS/TEN who were divided into two groups according to ocular severity at acute onset: non-severe ocular complications group (n = 27) and severe ocular complications group (n = 20). Multivariate logistic regression analysis revealed that disease severity (body surface area detachment ≥ 10%) was a predictive factor for acute SOCs, and older age (≥ 60 years) was marginally significantly predictive of SOCs. Serum biomarker levels of S100A8/A9 and granulysin were marginally significant and tended to increase in the SOC group. Therefore, during the early acute stage, focusing on disease severity, patient age, and serum inflammatory biomarkers (S100A8/A9 and granulysin) might help predict SOC progression in patients with SJS/TEN who need prompt and aggressive ocular management to prevent severe ocular sequelae.
史蒂文斯-约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）是具有高死亡率的严重药物不良反应性皮肤病。其后遗症，如失明，即使在康复后仍持续存在。SJS/TEN 患者应尽快准确诊断并接受适当治疗。因此，识别严重程度预测的因素是必要的。我们旨在阐明可预测 SJS/TEN 急性严重眼部并发症（SOC）的临床参数和生物标志物。这项回顾性横断面研究纳入了 47 例 SJS/TEN 患者，根据急性发作时眼部严重程度分为两组：非严重眼部并发症组（n=27）和严重眼部并发症组（n=20）。多变量逻辑回归分析显示，疾病严重程度（体表面积脱落≥10%）是急性 SOC 的预测因素，年龄较大（≥60 岁）是 SOC 的边缘显著预测因素。SOC 组血清生物标志物 S100A8/A9 和颗粒溶素水平略有升高。因此，在早期急性阶段，关注疾病严重程度、患者年龄和血清炎症生物标志物（S100A8/A9 和颗粒溶素）可能有助于预测需要及时积极眼部治疗以预防严重眼部后遗症的 SJS/TEN 患者 SOC 进展。
