1. Disseminated intravascular coagulation in Stevens-Johnson syndrome and toxic epidermal necrolysis.
- Author
-
Chen CB, Hsu TH, Chung-Yee Hui R, Lu CW, Chen WT, Chiang PH, Wang CW, Chuang SS, Yang JY, Yang SY, Chang SY, Hsiao YC, Kao KC, Hu HC, Wu TS, Hsu CW, Hui-Kang Ma D, Chen SY, Tian YC, Cheng CY, Chen CH, Chi MH, Wu MY, Liu RF, Wang CH, Chang YC, Lin JY, Ho HC, Yu-Wei Lin Y, Chang CJ, Lin YJ, Ku CL, Hung SI, and Chung WH
- Subjects
- Adult, Aged, Aged, 80 and over, Bacteremia complications, Bacteremia microbiology, Female, Humans, Kaplan-Meier Estimate, Liver Failure complications, Male, Middle Aged, Renal Insufficiency complications, Respiratory Insufficiency complications, Survival Rate, Disseminated Intravascular Coagulation etiology, Disseminated Intravascular Coagulation mortality, Gastrointestinal Hemorrhage complications, Stevens-Johnson Syndrome complications, Stevens-Johnson Syndrome mortality
- Abstract
Background: Patients with Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) have high mortality rates. Disseminated intravascular coagulation has been reported in SJS/TEN patients. The influence of this lethal complication in patients with SJS/TEN is not well known., Objective: This study aimed to investigate the risk and outcomes of disseminated intravascular coagulation in patients with SJS/TEN., Methods: We analyzed the disseminated intravascular coagulation profiles of patients receiving a diagnosis of SJS/TEN between 2010 and 2019., Results: We analyzed 150 patients with SJS/TEN (75 with SJS, 22 with overlapping SJS/TEN, and 53 with TEN) and their complete disseminated intravascular coagulation profiles. Disseminated intravascular coagulation was diagnosed in 32 patients (21.3%), primarily those with TEN. It was significantly associated with systemic complications, including gastrointestinal bleeding, respiratory failure, renal failure, liver failure, infection, and bacteremia. Additionally, SJS/TEN patients with disseminated intravascular coagulation had elevated procalcitonin levels. Among patients with SJS/TEN, disseminated intravascular coagulation was associated with a greater than 10-fold increase in mortality (78.1% vs 7%)., Limitations: The study limitations include small sample size and a single hospital system., Conclusion: Disseminated intravascular coagulation is a potential complication of SJS/TEN and associated with higher mortality. Early recognition and appropriate management of this critical complication are important for patients with SJS/TEN., (Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF