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  • Disseminated intravascular ...
    Chen, Chun-Bing; Hsu, Tsun-Hao; Chung-Yee Hui, Rosaline; Lu, Chun-Wei; Chen, Wei-Ti; Chiang, Pin-Hsuan; Wang, Chuang-Wei; Chuang, Shiow-Shuh; Yang, Jui-Yung; Yang, Shih-Yi; Chang, Shu-Ying; Hsiao, Yen-Chang; Kao, Kuo-Chin; Hu, Han-Chung; Wu, Ting-Shu; Hsu, Chao-Wei; Hui-Kang Ma, David; Chen, Shin-Yi; Tian, Ya-Chung; Cheng, Chi-Yuan; Chen, Chi-Hua; Chi, Min-Hui; Wu, Ming-Ying; Liu, Ren-Feng; Wang, Chi-Hui; Chang, Ya-Ching; Lin, Jing-Yi; Ho, Hsin-Chun; Yu-Wei Lin, Yang; Chang, Chee Jen; Lin, Yu-Jr; Ku, Cheng-Lung; Hung, Shuen-Iu; Chung, Wen-Hung

    Journal of the American Academy of Dermatology, June 2021, 2021-Jun, 2021-06-00, Letnik: 84, Številka: 6
    Journal Article

    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. This study aimed to investigate the risk and outcomes of disseminated intravascular coagulation in patients with SJS/TEN. We analyzed the disseminated intravascular coagulation profiles of patients receiving a diagnosis of SJS/TEN between 2010 and 2019. 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%). The study limitations include small sample size and a single hospital system. 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.