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Combination of Infliximab and High-Dose Intravenous Immunoglobulin for Toxic Epidermal Necrolysis: Successful Treatment of an Elderly Patient

Toxic epidermal necrolysis (TEN) is a rare, severe cutaneous adverse drug reaction with average mortality 25–35%, especially among elderly multimorbid patients. Established therapeutic guidelines do not exist and controversies underlie many of the presently suggested treatment regimens. Herein we pr...

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Autores principales: Patmanidis, Konstantinos, Sidiras, Anastasios, Dolianitis, Konstantinos, Simelidis, Dimitrios, Solomonidis, Christos, Gaitanis, Georgios, Bassukas, Ioannis D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505931/
https://www.ncbi.nlm.nih.gov/pubmed/23259092
http://dx.doi.org/10.1155/2012/915314
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author Patmanidis, Konstantinos
Sidiras, Anastasios
Dolianitis, Konstantinos
Simelidis, Dimitrios
Solomonidis, Christos
Gaitanis, Georgios
Bassukas, Ioannis D.
author_facet Patmanidis, Konstantinos
Sidiras, Anastasios
Dolianitis, Konstantinos
Simelidis, Dimitrios
Solomonidis, Christos
Gaitanis, Georgios
Bassukas, Ioannis D.
author_sort Patmanidis, Konstantinos
collection PubMed
description Toxic epidermal necrolysis (TEN) is a rare, severe cutaneous adverse drug reaction with average mortality 25–35%, especially among elderly multimorbid patients. Established therapeutic guidelines do not exist and controversies underlie many of the presently suggested treatment regimens. Herein we present the use of the recently described combination scheme of methylprednisolone (500 mg methylprednisolone bolus i.v.) followed by infliximab (5 mg/kg i.v.) and high-dose intravenous immunoglobulin (2 g/kg over 5 days) to treat an elderly, 74-year-old female patient with TEN (SCORTEN 3) within the premises of a district hospital. Already from the second day of hospitalization the skin condition markedly stabilized and the patient's status improved rapidly thereafter. She was discharged after 19 days in stationary care in excellent general condition and remained without any sequels 9 months afterwards. The present paper further supports the feasibility, efficacy, and safety of the proposed combination modality for the treatment of elderly patients with TEN, a population susceptible to more severe TEN.
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spelling pubmed-35059312012-12-20 Combination of Infliximab and High-Dose Intravenous Immunoglobulin for Toxic Epidermal Necrolysis: Successful Treatment of an Elderly Patient Patmanidis, Konstantinos Sidiras, Anastasios Dolianitis, Konstantinos Simelidis, Dimitrios Solomonidis, Christos Gaitanis, Georgios Bassukas, Ioannis D. Case Rep Dermatol Med Case Report Toxic epidermal necrolysis (TEN) is a rare, severe cutaneous adverse drug reaction with average mortality 25–35%, especially among elderly multimorbid patients. Established therapeutic guidelines do not exist and controversies underlie many of the presently suggested treatment regimens. Herein we present the use of the recently described combination scheme of methylprednisolone (500 mg methylprednisolone bolus i.v.) followed by infliximab (5 mg/kg i.v.) and high-dose intravenous immunoglobulin (2 g/kg over 5 days) to treat an elderly, 74-year-old female patient with TEN (SCORTEN 3) within the premises of a district hospital. Already from the second day of hospitalization the skin condition markedly stabilized and the patient's status improved rapidly thereafter. She was discharged after 19 days in stationary care in excellent general condition and remained without any sequels 9 months afterwards. The present paper further supports the feasibility, efficacy, and safety of the proposed combination modality for the treatment of elderly patients with TEN, a population susceptible to more severe TEN. Hindawi Publishing Corporation 2012 2012-10-09 /pmc/articles/PMC3505931/ /pubmed/23259092 http://dx.doi.org/10.1155/2012/915314 Text en Copyright © 2012 Konstantinos Patmanidis et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Patmanidis, Konstantinos
Sidiras, Anastasios
Dolianitis, Konstantinos
Simelidis, Dimitrios
Solomonidis, Christos
Gaitanis, Georgios
Bassukas, Ioannis D.
Combination of Infliximab and High-Dose Intravenous Immunoglobulin for Toxic Epidermal Necrolysis: Successful Treatment of an Elderly Patient
title Combination of Infliximab and High-Dose Intravenous Immunoglobulin for Toxic Epidermal Necrolysis: Successful Treatment of an Elderly Patient
title_full Combination of Infliximab and High-Dose Intravenous Immunoglobulin for Toxic Epidermal Necrolysis: Successful Treatment of an Elderly Patient
title_fullStr Combination of Infliximab and High-Dose Intravenous Immunoglobulin for Toxic Epidermal Necrolysis: Successful Treatment of an Elderly Patient
title_full_unstemmed Combination of Infliximab and High-Dose Intravenous Immunoglobulin for Toxic Epidermal Necrolysis: Successful Treatment of an Elderly Patient
title_short Combination of Infliximab and High-Dose Intravenous Immunoglobulin for Toxic Epidermal Necrolysis: Successful Treatment of an Elderly Patient
title_sort combination of infliximab and high-dose intravenous immunoglobulin for toxic epidermal necrolysis: successful treatment of an elderly patient
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505931/
https://www.ncbi.nlm.nih.gov/pubmed/23259092
http://dx.doi.org/10.1155/2012/915314
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