title: Hematological abnormalities and the use of granulocyte-colony-stimulating factor in patients with Stevens-Johnson syndrome and toxic epidermal necrolysis.
abstract: BACKGROUND
  Derangements in blood cell counts have been described in patients with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) but are not well characterized. We aim to describe the relationship between our patients' hematological results and the evolution of disease and hypothesize on the possible roles of granulocyte-colony-stimulating factor (G-CSF) in the management of these conditions.
  
  
  METHODS
  Clinical records of our patients with SJS and TEN from January 2005 to 2010 were analyzed.
  
  
  RESULTS
  Anemia and lymphopenia were most commonly seen, while thrombocytopenia was uncommon. Leukopenia and neutropenia were seen in patients with more severe disease, and the trend of leukopenia and neutropenia followed the evolution of disease. Two patients received G-CSF for febrile neutropenia and had a rapid recovery of their neutrophil counts as well as a shorter time to re-epithelialization.
  
  
  CONCLUSIONS
  Our patients tended to have leukopenia and neutropenia that followed a predictable trend of decline and subsequent improvement depending on the stage of disease. This may be of pathogenic significance, and G-CSF may be used in these cases to manage febrile neutropenia and aid re-epithelialization. Further basic science research is required to prove our hypotheses.
authors.affiliation: Department of Dermatology, Changi General Hospital, Singapore. angchiachun@gmail.com
authors.forename: Chia-Chun
authors.initials: CC
authors.lastname: Ang
authors.forename: Yong-Kwang
authors.initials: YK
authors.lastname: Tay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005334:Fever / Q000188:drug therapy; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000188:drug therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013262:Stevens-Johnson Syndrome / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D016179:Granulocyte Colony-Stimulating Factor