Five years of a single burn center experience with toxic epidermal necrolysis: retrospective study of causative drugs and the clinical outcome

  • سال انتشار: 1401
  • محل انتشار: مجله پزشکی بالینی، دوره: 9، شماره: 2
  • کد COI اختصاصی: JR_RCM-9-2_003
  • زبان مقاله: انگلیسی
  • تعداد مشاهده: 199
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نویسندگان

Alireza Sedaghat

Lung disease research center, Faculty of Medicine, Mashhad university of Medical Sciences, Mashhad, Iran

Ali Ahmadabadi

Surgical Oncology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran.

Seyed Hassan Tavousi

Surgical Oncology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran.

Benyamin Fazli

Assistant professor of Intensive Care medicine, Department of anesthesiology, Faculty of Medicine, Mashhad university of Medical Sciences, Mashhad, Iran.

Mahmood Khorsand

Sub specially in Critical Care Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Bita Mirzaie Feyzabadi

Post Doctorate of psychosomatic medicine, Mashhad University of Medical Sciences, Mashhad, Iran

چکیده

Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare, but potentially life-threatening reactions to medications. Both conditions have significant morbidity and mortality. This study aimed to document the epidemiological features, aetiologies, treatment and clinical outcomes of such patients.Method: In this retrospective cross-sectional study the records of all patients with TEN treated for۵ years in central Hospital, Mashhad, Iran were reviewed. Results: Thirty-four patients were studied with a mean age of ۲۶.۵ years. Mean age in the mortality and survivors groups was ۳۳.۶ and ۲۵.۳ years, respectively. Drugs accounted for all ۳۴ cases were including Anti-convulsants (۵۲.۹%) other the most common implicated drug followed by antibiotics (۲۶.۵%), allopurinol (۵.۹%) and multiple drugs (anticonvulsants plus antibiotics) (۱۴.۷%). Antibiotics had the shortest interval between ingestion time and onset of symptoms. The mean ICU length of stay was ۱۲.۷ days, with a range of ۱ to ۳۰ days. The mean of SCORTEN was ۲.۳; it was ۳.۳ and ۲.۱ in the mortality and survivors group, respectively (P=۰.۰۰۱).All ۳۴ TEN cases were given intravenous immunoglobulins (IVIG). Six patients with TEN died (۱۷.۶%). The highest mortality was found in the allopurinol group with ۵۰%, whereas anticonvulsants and antibiotics had a mortality rate of ۱۶.۶% and ۱۵.۳%, respectively.Conclusion: Anti-convulsants especially Lamotrigine were the most frequently implicated drug, followed by antibiotics and allopurinol. IVIG was shown beneficial effects in TEN syndrome.

کلیدواژه ها

Toxic epidermal necrolysis (TEN), drug, Anticonvulsants, Mortality

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