Causes and Treatment Outcomes of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in 82 Adult Patients
The Korean Journal of Internal Medicine
;
: 203-210, 2012.
Article
in English
| WPRIM
| ID: wpr-28110
ABSTRACT
BACKGROUND/AIMS:
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are predominantly known as medication-induced diseases. However, at our institution, we have experienced more cases of non-drug-related SJS and TEN than expected. Therefore, we studied the difference between non-drug-related and drug-related SJS and TEN in terms of clinical characteristics and prognoses.METHODS:
The etiologies, clinical characteristics, and treatment outcomes for 82 adult patients with SJS and TEN were retrospectively reviewed.RESULTS:
A total of 71 patients (86.6%) were classified as having SJS, and the other 11 patients (13.4%) were classified as having TEN. Drug-related cases were more common (43, 52.4%) than non-drug-related cases (39, 47.6%). Anticonvulsants (12/82, 14.6%) and antibiotics (9/82, 11%) were the most common causative medications. Anemia (p = 0.017) and C-reactive protein of > or = 5 mg/dL (p = 0.026) were more common in the drug-related cases than in the non-drug-related cases. Intravenous steroid therapy was used as the main treatment regimen (70/82, 85.4%). Of the 82 patients, 8 (9.8%) died during the clinical course. A univariate analysis for mortality showed statistical significance for the following kidney function abnormality, pneumonia, hemoglobin of < 10 g/dL, and combined underlying diseases. In a multivariate analysis, only pneumonia was statistically significant (odds ratio, 25.79; p = 0.009).CONCLUSIONS:
Drugs were the most frequent cause of these diseases. However, non-drug-related causes also contributed to a significant proportion of cases. Physicians should keep this in mind when documenting patient history. In addition, early recognition and treatment may be important for better outcomes.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Chi-Square Distribution
/
Logistic Models
/
Odds Ratio
/
Survival Analysis
/
Multivariate Analysis
/
Risk Factors
/
Stevens-Johnson Syndrome
/
Treatment Outcome
/
Risk Assessment
/
Republic of Korea
Type of study:
Etiology study
/
Prognostic study
Limits:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
English
Journal:
The Korean Journal of Internal Medicine
Year:
2012
Type:
Article
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