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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.
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
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