Treatment of severe adverse cutaneous drug reactions with human intravenous immunoglobulin in two dogs.

Severe adverse cutaneous reactions were documented in two dogs with acute skin lesions and systemic signs after exposure to several oral and injectable drugs. Because of the high morbidity and mortality rates of many severe cutaneous drug reactions and a poor response to supportive care, wound management, and conventional immunosuppressive therapy, human intravenous immunoglobulin (IVIG) was infused on 2 consecutive days (1 g/kg per day) after informed consent was received. Human IVIG, with supportive care, resulted in rapid resolution of dermatological and systemic signs in both dogs; this treatment may be considered in other cases of severe cutaneous drug reactions.

[1]  Martine Bagot,et al.  Toxic epidermal necrolysis: effector cells are drug-specific cytotoxic T cells. , 2004, The Journal of allergy and clinical immunology.

[2]  T. Nuttall,et al.  Successful intravenous human immunoglobulin treatment of drug-induced Stevens-Johnson syndrome in a dog. , 2004, The Journal of small animal practice.

[3]  M. Blanca,et al.  Improvement of toxic epidermal necrolysis after the early administration of a single high dose of intravenous immunoglobulin. , 2003, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[4]  R. Kirsner,et al.  Analysis of intravenous immunoglobulin for the treatment of toxic epidermal necrolysis using SCORTEN: The University of Miami Experience. , 2003, Archives of dermatology.

[5]  R. S. Padilla,et al.  Treatment of toxic epidermal necrolysis with high-dose intravenous immunoglobulins: multicenter retrospective analysis of 48 consecutive cases. , 2003, Archives of dermatology.

[6]  W. Rising,et al.  Outcome of Patients with Toxic Epidermal Necrolysis Syndrome Revisited , 2002, Plastic and reconstructive surgery.

[7]  U. Giger,et al.  Use of human immunoglobulin for treatment of severe erythema multiforme in a cat. , 2002, Journal of the American Veterinary Medical Association.

[8]  W. Miller,et al.  Immune-Mediated Disorders , 2001, Muller & Kirk's Small Animal Dermatology.

[9]  P. Damas,et al.  Treatment of drug-induced toxic epidermal necrolysis (Lyell's syndrome) with intravenous human immunoglobulins. , 2001, Burns : journal of the International Society for Burn Injuries.

[10]  M. Stella,et al.  Toxic Epidermal Necrolysis Treated with Intravenous High-Dose Immunoglobulins: Our Experience , 2001, Dermatology.

[11]  T. Luger,et al.  High-dose intravenous immunoglobulins: an approach to treat severe immune-mediated and autoimmune diseases of the skin. , 2001, Journal of the American Academy of Dermatology.

[12]  F. Puppo,et al.  Fas, Fas ligand,and transfusion immunomodulation , 2001, Transfusion.

[13]  J. Tschopp,et al.  Death receptors in cutaneous biology and disease. , 2000, The Journal of investigative dermatology.

[14]  S. Magina,et al.  A case of toxic epidermal necrolysis treated with intravenous immunoglobulin , 1998, The British journal of dermatology.

[15]  Miller,et al.  Erythema multiforme in dogs and cats: literature review and case material from the Cornell University College of Veterinary Medicine (1988-96). , 1999, Veterinary dermatology.

[16]  J. Tschopp,et al.  Inhibition of toxic epidermal necrolysis by blockade of CD95 with human intravenous immunoglobulin. , 1998, Science.

[17]  J. Roujeau,et al.  Drug-induced toxic epidermal necrolysis. , 1998, Clinics in dermatology.

[18]  D. Becker.  Toxic epidermal necrolysis , 1969, The Lancet.

[19]  D. Bruyette,et al.  Intravenous human immunoglobulin for the treatment of immune-mediated hemolytic anemia in 13 dogs. , 1997, Journal of veterinary internal medicine.

[20]  S. Jordan,et al.  Treatment of Stevens-Johnson Syndrome With Pooled Human Intravenous Immune Globulin , 1995, Clinical pediatrics.

[21]  R. Stern,et al.  Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme. , 1993, Archives of dermatology.

[22]  J. Roujeau,et al.  Toxic epidermal necrolysis (Lyell syndrome). , 1990, Journal of the American Academy of Dermatology.

[23]  D. Panciera,et al.  Management of cryptococcosis and toxic epidermal necrolysis in a dog. , 1987, Journal of the American Veterinary Medical Association.