מחקר רטרוספקטיבי של חולים עם SJS/TEN שטופלו במרכז שלישוני לכוויות בקנדה – הערכה של 17 שנות טיפול

Cristina Olteanu ² Marc Jeschke ¹ Neil Shear ³ Rena Hashimoto ³ Marjorie Burnett ¹ Michael Ziv ⁴ Roni Dodiuk-Gad ^3,4

¹Ross Tilley Burn Centre,, Sunnybrook Health Sciences Centre, קנדה
²Department of Medicine, Division of Dermatology, University of Alberta, קנדה
³Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, קנדה
⁴Dermatology Department, Emek Medical Center, Bruce Rappaport Faculty of Medicine, Technion-Institute of Technology, ישראל

Background: Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are adverse drug reactions, predominantly elicited by drugs.

Objectives: To learn about the clinical characteristics of patients with SJS/TEN including treatments provided, outcomes, and mortality.

Methods: We conducted a retrospective chart review of patients who were hospitalized with the diagnosis of SJS/TEN at the Ross Tilley Burn Centre between the years: 1999-2015.

Results:

A total of 43 patients were identified with a mean age of 54±19 (58, 18-85). The most common offending medications were allopurinol and carbamazepine. The overall mortality rate in our study is 21% with the most common causes of death being multi-organ failure and sepsis. The majority of our patients had oral (84%), ocular (79%), and genital (60%) involvement during hospitalization. Our data revealed that combination treatment involving oral corticosteroids with IVIG had the highest mortality rate in our study since 55% (6/11) of patients who were treated in this manner passed away comparing to 11% (2/18) of patients passing away who were treated with solely IVIG and 33% (1/3) who were treated with only supportive care. Our study also demonstrates an addition of Enbrel and cyclosporine treatment in the second time period we studied: 2008-2015 versus the earlier time period of 1999-2007. None of the patients in our study who were treated with therapies including cyclosporine and/or Enbrel passed away.

Conclusions:

Our study sheds light on a possible beneficial role of cyclosporine and etanercept for treatment of SJS and TEN and reinforces the necessity of a multi-disciplinary care team for patients.