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Original Article
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Korean J Med. 2009;77(5):1119-1123.
- 간경변증 환자에서 면역글로불린으로 치료한 독성표피괴사융해 1예
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황세웅·김석현·성재규·이병석·이헌영·이상신·서영준, , , , , ,
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- Toxic epidermal necrolysis treated with high-dose intravenous immunoglobulin in a patient with liver cirrhosis
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Se Woong Hwang, Seok Hyun Kim, Jae Kyu Seong, Byung Seok Lee, Heon Young Lee, Sang Sin Lee, Young Joon Seo
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- Abstract
- Departments of 1Internal Medicine and 2Dermatology,
Chungnam National University College of Medicine, Daejeon, Korea
Toxic epidermal necrolysis (TEN) is a very dramatic, life-threatening mucocutaneous drug reaction. TEN is characterized by extensive
detachment of the epidermis. A 53-year-old man with advanced liver cirrhosis had been treated with lamotrigine
(Lamictal?) for a convulsive disorder for 7 months before being admitted to hospital with diffuse erythematous maculopapular lesions
with extensive confluence that developed on the neck, chest, back, upper arms and thighs and bled spontaneously. The skin lesions
worsened rapidly during the initial period of admission despite systemic steroid treatment. Therefore, we tried treating the
TEN with high-dose intravenous immunoglobulin (IVIG; 0.5 g/kg/day for 4 consecutive days). The progression of the epidermal
detachment stopped within 3 days of starting the IVIG treatment and re-epithelialization was completed in 5 weeks without significant
side effects of IVIG. Here, we report a case of life-threatening TEN treated with high-dose IVIG in a patient with advanced
liver cirrhosis. (Korean J Med 77:S1119-S1123, 2009)
Keywords :Toxic epidermal necrolysis, Immunoglobulin, Liver cirrhosis, Lamotrigine
