Outcomes of StevensJohnson syndrome and toxic epidermal necrolysis in HIV-infected patients when using systemic steroids and/or intravenous immunoglobulins in Pietermaritzburg, South Africa
South. Afr. j. HIV med. (Online)
; 20(1): 1-8, 2019. tab
Artigo
em Inglês
| AIM (África)
| ID: biblio-1272217
Biblioteca responsável:
CG1.1
ABSTRACT
Background:
StevensJohnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe life-threatening mucocutaneous reactions. There is an ongoing controversy regarding the use of systemic corticosteroids and intravenous immunoglobulin (IVIG) in SJS/TEN and their utility in HIV-infected patients.Objectives:
The objective was to assess the outcome of a combination of intensive supportive care with oral corticosteroids in SJS and a combination of systemic steroids and IVIG for 3 consecutive days in HIV-infected patients with TEN. In addition, we assessed management in a general dermatology ward without implementing wound debridement.Methods:
This was a retrospective cohort study of 36 HIV-infected adults with SJS/TEN admitted to a tertiary dermatology unit between 1st January 2010 and 31st July 2011. Standard-of-care protocols included identification and elimination of the possible causative drug, meticulous wound care without debridement, initiation of oral prednisone (1 mg/kg/day) on admission for 3 consecutive days, and the addition of IVIG (1 g/kg/day) for 3 consecutive days to those with TEN.Results:
Of the 36 patients in the study, 32 were female. Nevirapine was the commonest drug implicated. A diagnosis of tuberculosis did not increase the case fatality rate.Complications included infections, anaemia, drug-induced hepatitis, ocular involvement, renal impairment, deep vein thrombosis, respiratory distress, Leucopenia, gastritis and hypernatremia. The overall survival rate was 97%.Conclusion:
HIV-infected SJS and TEN patients were treated in a tertiary dermatology ward with a treatment plan of skin care, and a combination of systemic corticosteroids and IVIG respectively had a survival rate of 97%
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Contexto em Saúde:
Doenças Negligenciadas
Problema de saúde:
Tuberculose
Base de dados:
AIM (África)
Assunto principal:
África do Sul
/
Síndrome de Stevens-Johnson
/
Imunoglobulinas Intravenosas
Tipo de estudo:
Guia de prática clínica
/
Estudo observacional
País/Região como assunto:
África
Idioma:
Inglês
Revista:
South. Afr. j. HIV med. (Online)
Ano de publicação:
2019
Tipo de documento:
Artigo