Treatment of allopurinol-induced toxic epidermal necrolysis with high dose corticosteroids and intravenous immunoglobulins
Abstract
Toxic epidermal necrolysis (TEN) is an uncommon, acute and severe adverse reaction triggered by drugs, infections and malignancies. Drugs are the main cause of the disease. The most common drugs are sulfonamides and penicillins and the most often associated infectious agent is herpes simplex virus. Allopurinol is the first line drug for serum lowering therapy in gout and is approved by the US Food and Drug Administration (FDA). In recent studies, allopurinol was found to be the most commonly associated drug causing life-threatening drug reactions. Here, we aimed to present a rare case of TEN induced by allopurinol, the efficacy/harm of high dose systemic corticosteroids and use of intravenous immunoglobulins (IVIg) in the treatment of TEN
Keywords
References
- 1. Wong A, Malvestiti AA, Hafner MFS. Stevens-Johnson syndrome and toxic epidermal necrolysis: a review. Rev Assoc Med Bras. 2016;62(5):468-73.
- 2. Lee HY, Lim YL, Thirumoorthy T, Pang SM. The role of intravenous immunoglobulin in toxic epidermal necrolysis: a retrospective analysis of 64 patients managed in a specialized centre. Br J Dermatol. 2013 Dec;169(6):1304-9.
- 3. Kinoshita Y, Saeki H. A review of toxic epidermal necrolysis management in Japan. Allergol Int. 2017 Jan;66(1):36-41.
- 4. Tangamornsuksan W, Lohitnavy O, Lohitnavy M . Association of HLA-B* 5801 allele and allopurinol-induced Stevens Johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis. BMC Medical Genetics. 2011;12:118.
- 5. Bastuji-Garin S, Fouchard N, Bertocchi M, Roujeau JC, Revuz J, Wolkenstein P. SCORTEN: a severity-of-illness score for toxic epidermal necrolysis. J Invest Dermatol. 2000;115(2):149-53.
- 6. Kinoshita Y, Saeki H. A review of the active treatments for toxic epidermal necrolysis. J Nippon Med Sch. 2017;84(3):110-7.
- 7. Liang-ping Ye, Cheng Zhang, Qi-xing Zhu. The effect of intravenous immunoglobulin combined with corticosteroid on the progression of Stevens-Johnson syndrome and toxic epidermal necrolysis: a meta-analysis. PloS one. 2016;11(11).
- 8. Ng CY, Yeh YT, Wang CW, Hung SI, Yang CH, Chang YC, et al. Impact of the HLA-B* 58:01 allele and renal impairment on allopurinol-induced cutaneous adverse reactions. J Invest Dermatol. 2016 Jul;136(7):1373-81.
Details
Primary Language
English
Subjects
Dermatology
Journal Section
Case Report
Authors
Mehmet Akyürek
This is me
0000-0002-8141-3186
Türkiye
Publication Date
July 29, 2019
Submission Date
March 14, 2019
Acceptance Date
July 17, 2019
Published in Issue
Year 2019 Volume: 3 Number: 7