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Disseminated intravascular coagulation in Stevens-Johnson syndrome and toxic epidermal necrolysis.
Chen, Chun-Bing; Hsu, Tsun-Hao; Chung-Yee Hui, Rosaline; Lu, Chun-Wei; Chen, Wei-Ti; Chiang, Pin-Hsuan; Wang, Chuang-Wei; Chuang, Shiow-Shuh; Yang, Jui-Yung; Yang, Shih-Yi; Chang, Shu-Ying; Hsiao, Yen-Chang; Kao, Kuo-Chin; Hu, Han-Chung; Wu, Ting-Shu; Hsu, Chao-Wei; Hui-Kang Ma, David; Chen, Shin-Yi; Tian, Ya-Chung; Cheng, Chi-Yuan; Chen, Chi-Hua; Chi, Min-Hui; Wu, Ming-Ying; Liu, Ren-Feng; Wang, Chi-Hui; Chang, Ya-Ching; Lin, Jing-Yi; Ho, Hsin-Chun; Yu-Wei Lin, Yang; Chang, Chee Jen; Lin, Yu-Jr; Ku, Cheng-Lung; Hung, Shuen-Iu; Chung, Wen-Hung.
Afiliação
  • Chen CB; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung Univers
  • Hsu TH; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Chung-Yee Hui R; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Lu CW; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung Univers
  • Chen WT; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Chiang PH; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Wang CW; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung Univers
  • Chuang SS; Department of Plastic and Reconstructive Surgery, The Burn Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Yang JY; Department of Plastic and Reconstructive Surgery, The Burn Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Yang SY; Department of Plastic and Reconstructive Surgery, The Burn Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Chang SY; Department of Plastic and Reconstructive Surgery, The Burn Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Hsiao YC; Department of Plastic and Reconstructive Surgery, The Burn Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Kao KC; Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Clinical Informatics Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Hu HC; Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Clinical Informatics Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Wu TS; Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kweishan, Taoyuan, Taiwan.
  • Hsu CW; Department of Hepatogastroenterology, Liver Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Hui-Kang Ma D; Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
  • Chen SY; Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.
  • Tian YC; Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
  • Cheng CY; Department of Pharmacy, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
  • Chen CH; Department of Pharmacy, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
  • Chi MH; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Wu MY; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Liu RF; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Wang CH; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Chang YC; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Lin JY; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Ho HC; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
  • Yu-Wei Lin Y; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan.
  • Chang CJ; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Research Services Center for Health Information, Chang Gung University, Taoyuan, Taiwan; Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan.
  • Lin YJ; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Research Services Center for Health Information, Chang Gung University, Taoyuan, Taiwan; Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan.
  • Ku CL; Laboratory of Human Immunology and Infectious Disease, Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan; Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
  • Hung SI; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
  • Chung WH; Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, Keelung, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan;
J Am Acad Dermatol ; 84(6): 1782-1791, 2021 Jun.
Article em En | MEDLINE | ID: mdl-32828861
ABSTRACT

BACKGROUND:

Patients with Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) have high mortality rates. Disseminated intravascular coagulation has been reported in SJS/TEN patients. The influence of this lethal complication in patients with SJS/TEN is not well known.

OBJECTIVE:

This study aimed to investigate the risk and outcomes of disseminated intravascular coagulation in patients with SJS/TEN.

METHODS:

We analyzed the disseminated intravascular coagulation profiles of patients receiving a diagnosis of SJS/TEN between 2010 and 2019.

RESULTS:

We analyzed 150 patients with SJS/TEN (75 with SJS, 22 with overlapping SJS/TEN, and 53 with TEN) and their complete disseminated intravascular coagulation profiles. Disseminated intravascular coagulation was diagnosed in 32 patients (21.3%), primarily those with TEN. It was significantly associated with systemic complications, including gastrointestinal bleeding, respiratory failure, renal failure, liver failure, infection, and bacteremia. Additionally, SJS/TEN patients with disseminated intravascular coagulation had elevated procalcitonin levels. Among patients with SJS/TEN, disseminated intravascular coagulation was associated with a greater than 10-fold increase in mortality (78.1% vs 7%).

LIMITATIONS:

The study limitations include small sample size and a single hospital system.

CONCLUSION:

Disseminated intravascular coagulation is a potential complication of SJS/TEN and associated with higher mortality. Early recognition and appropriate management of this critical complication are important for patients with SJS/TEN.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome de Stevens-Johnson / Coagulação Intravascular Disseminada / Hemorragia Gastrointestinal Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Acad Dermatol Ano de publicação: 2021 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Síndrome de Stevens-Johnson / Coagulação Intravascular Disseminada / Hemorragia Gastrointestinal Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Am Acad Dermatol Ano de publicação: 2021 Tipo de documento: Article