Skin immunoglobulin deposition following intravenous immunoglobulin therapy in toxic epidermal necrolysis

Experimental Dermatology
P PaquetG E Piérard

Abstract

Human intravenous immunoglobulins (IVIg) which contain anti-CD95 antibodies have been proposed to treat toxic epidermal necrolysis (TEN). Presently, there is no evidence that IVIg reach the keratinocytes in TEN patients. The aim of this study was to assess the Ig distribution in the serum, blister fluid and skin of six consecutive TEN patients treated with IVIg (1 g/kg/day) for 3 days. They were compared with five TEN patients who only received supportive therapy. In all patients, IgA, IgM and IgG concentrations were measured in the serum and blister fluid using an immuno-nephelometric method. Immunohistochemistry was performed on skin biopsies taken from both TEN clinically involved and uninvolved skin to search for IgG deposits. On admission, the IgG concentrations were significantly higher in both TEN serum and TEN blister fluid compared with their respective IgA and IgM contents. The IgG, IgA and IgM concentrations in blister fluid were significantly lower than their respective serum concentrations. The serum and blister fluid IgG concentrations, but not that of IgA and IgM, were markedly increased at the completion of the IVIg treatment. By contrast, they remained unchanged in the TEN patients that were untreated with IVIg...Continue Reading

References

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Citations

May 29, 2009·Current Opinion in Pediatrics·Mark Jean-Aan Koh, Yong-Kwang Tay
Jan 1, 2011·Revista brasileira de hematologia e hemoterapia·Marcia Cristina Zago Novaretti, Carla Luana Dinardo
Feb 18, 2016·International Journal of Inflammation·Lyubomir A DourmishevLjubka G Miteva
Oct 21, 2006·Journal of the American Academy of Dermatology·Warren R Heymann
Jul 11, 2006·Annales Françaises D'anesthèsie Et De Rèanimation·G MionJ-L Daban
Feb 18, 2010·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Philippe Paquet, Gérald E Piérard
Apr 20, 2021·Indian Journal of Dermatology, Venereology and Leprology·Tejas K PatelSejal Thakkar

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