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Disseminated intravascular coagulation in Stevens-Johnson syndrome and toxic epidermal necrolysis
- Source :
- Journal of the American Academy of Dermatology. 84(6)
- Publication Year :
- 2020
-
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.
- Subjects :
- Adult
Male
medicine.medical_specialty
Gastrointestinal bleeding
Bacteremia
Dermatology
Kaplan-Meier Estimate
Procalcitonin
030207 dermatology & venereal diseases
03 medical and health sciences
0302 clinical medicine
medicine
Coagulopathy
Humans
Renal Insufficiency
Aged
Disseminated intravascular coagulation
Aged, 80 and over
business.industry
Disseminated Intravascular Coagulation
Middle Aged
medicine.disease
Toxic epidermal necrolysis
Survival Rate
stomatognathic diseases
Respiratory failure
030220 oncology & carcinogenesis
Stevens-Johnson Syndrome
Female
Complication
business
Gastrointestinal Hemorrhage
Respiratory Insufficiency
Liver Failure
Subjects
Details
- ISSN :
- 10976787
- Volume :
- 84
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of the American Academy of Dermatology
- Accession number :
- edsair.doi.dedup.....299ebc2187b7d4346119f9523f310915