Toxic epidermal necrolysis in acquired immunodeficiency syndrome treated with intravenous gammaglobulin.
A 31-year-old man with the acquired immunodeficiency syndrome who developed toxic epidermal necrolysis (TEN) was successfully treated with intravenous immunoglobulin. He presented with a widespread, blistering skin rash, extensive mucosal ulceration, high-grade fever and pancytopaenia. Nevirapine, a non-nucleoside reverse transcriptase inhibitor, was suspected as the culprit drug, although the patient had been taking this medication for 6 months. The patient also demonstrated an increased number of gamma/delta (gamma delta) T cells that decreased concomitantly with his clinical improvement. This correlation has not been described in TEN previously and may be of pathophysiological significance.
Phan
T G
TG
Department of Clinical Immunology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia. tri@immu.rpa.cs.nsw.gov.au
Wong
R C
RC
Crotty
K
K
Adelstein
S
S
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D008297:Male; D019829:Nevirapine / Q000009:adverse effects*; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000378:metabolism; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects*; D012867:Skin / Q000473:pathology; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
D019380:Anti-HIV Agents; D016756:Immunoglobulins, Intravenous; D016692:Receptors, Antigen, T-Cell, gamma-delta; D018894:Reverse Transcriptase Inhibitors; D019829:Nevirapine