0
Correspondence |

Intravenous Immunoglobulin for the Treatment of Toxic Epidermal Necrolysis

Jennifer T. Trent, MD; Francisco A. Kerdel, BSc, MBBS
[+] Author Affiliations

Copyright 2003 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

More Author Information
Arch Dermatol. 2003;139(8):1081-1081. doi:10.1001/archderm.139.8.1081-a
Text Size: A A A
Published online

We would like the opportunity to respond to the comments by Wolff and Tappeiner1 regarding the lack of information on the brands of intravenous immunoglobulin (IVIG) used in our study2 to treat 16 patients with toxic epidermal necrolysis (TEN). Six patients received Immune Globulin 10 (Bayer), 6 Gamimmune (Bayer), 2 Gammar P (Bayer), 1 Polygam (American Red Cross), and 1 received both Gamimmune and Gammar P (2 doses of each). Our only fatality, a patient who died of a myocardial infarction after her TEN had resolved, had been treated with Gammar P IVIG. While we did not test each batch of IVIG for Fas-FasL activity, in retrospect, the different brands of IVIG did not appear to make any difference in the clinical outcome.

While we agree that there is still controversy surrounding the treatment of TEN with IVIG, the largest therapeutic study to date by Prins et al,3 in addition to our study, represent among the lowest mortality rates reported (12% and 6.5%, respectively) in patients with TEN since its description by Lyell in 1956. This important fact was not mentioned in the editorial1 but should be emphasized.

The authors have no relevant financial interest in this letter.

REFERENCES

Wolff  K, Tappeiner  G. Treatment of toxic epidermal necrolysis: the uncertainty persists but the fog is dispersing [editorial]. Arch Dermatol. 2003;13985- 86
CrossRef
Trent  JT, Kirsner  RS, Romanelli  P, Kerdel  FA. Analysis of intravenous immunoglobulin for the treatment of toxic epidermal necrolysis using SCORTEN: the University of Miami Experience. Arch Dermatol. 2003;13939- 43
CrossRef
Prins  C, Kerdel  FA, Padilla  S.  et al.  Treatment of toxic epidermal necrolysis with high-dose intravenous immunoglobulin: multicenter retrospective analysis of 48 consecutive cases. Arch Dermatol. 2003;13926- 32
CrossRef

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Wolff  K, Tappeiner  G. Treatment of toxic epidermal necrolysis: the uncertainty persists but the fog is dispersing [editorial]. Arch Dermatol. 2003;13985- 86
CrossRef
Trent  JT, Kirsner  RS, Romanelli  P, Kerdel  FA. Analysis of intravenous immunoglobulin for the treatment of toxic epidermal necrolysis using SCORTEN: the University of Miami Experience. Arch Dermatol. 2003;13939- 43
CrossRef
Prins  C, Kerdel  FA, Padilla  S.  et al.  Treatment of toxic epidermal necrolysis with high-dose intravenous immunoglobulin: multicenter retrospective analysis of 48 consecutive cases. Arch Dermatol. 2003;13926- 32
CrossRef

Correspondence

CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 1

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles