Tan YW, Liu LP, Zhang K. Double plasma molecular adsorption system for Stevens–Johnson syndrome/toxic epidermal necrolysis: A case report. World J Clin Cases 2024; 12(7): 1371-1377 [PMID: 38524512 DOI: 10.12998/wjcc.v12.i7.1371]
Corresponding Author of This Article
You-Wen Tan, MD, Chief Doctor, Professor, Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, No. 300 Daijiamen, Runzhou Distinct, Zhenjiang 212003, Jiangsu Province, China. tyw915@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 6, 2024; 12(7): 1371-1377 Published online Mar 6, 2024. doi: 10.12998/wjcc.v12.i7.1371
Double plasma molecular adsorption system for Stevens–Johnson syndrome/toxic epidermal necrolysis: A case report
You-Wen Tan, Li-Ping Liu, Kai Zhang
You-Wen Tan, Li-Ping Liu, Kai Zhang, Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, Zhenjiang 212003, Jiangsu Province, China
Author contributions: Tan YW, Liu LP and Zhang K contributed equally to the research, Tan YW designed the research; Liu LP and Zhang K collected and analyzed the data, and drafted the manuscript; Tan YW, Liu LP and Zhang K wrote and revised the manuscript; all authors have read and approved the final version to be published.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: You-Wen Tan, MD, Chief Doctor, Professor, Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, No. 300 Daijiamen, Runzhou Distinct, Zhenjiang 212003, Jiangsu Province, China. tyw915@sina.com
Received: December 31, 2023 Peer-review started: December 31, 2023 First decision: January 16, 2024 Revised: January 19, 2024 Accepted: February 8, 2024 Article in press: February 8, 2024 Published online: March 6, 2024 Processing time: 60 Days and 20 Hours
Abstract
BACKGROUND
Stevens–Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are very serious skin allergies, with an etiology related to infections and medication. Since the coronavirus disease 2019 (COVID-19) pandemic, severe acute respiratory syndrome coronavirus-2 has also been considered to cause SJS/TEN.
CASE SUMMARY
We report the case of a woman in her thirties who took acetaminophen after contracting COVID-19. After 3 d of fever relief, she experienced high fever and presented with SJS/TEN symptoms, accompanied by intrahepatic cholestasis. Three days of corticosteroid treatment did not alleviate the skin damage; therefore, double plasma molecular adsorption system (DPMAS) therapy was initiated, with treatment intervals of 48 h. Her skin symptoms improved gradually and were resolved after seven DPMAS treatments.
CONCLUSION
DPMAS therapy is beneficial for abrogating SJS/TEN because plasma adsorption and perfusion techniques reduce the inflammatory mediators (e.g., tumor necrosis factor-alpha and interleukin-10 and-12) speculated to be involved in the pathology of the skin conditions.
Core Tip: A woman in her thirties took acetaminophen after contracting coronavirus disease 2019. After 3 d of fever relief, she experienced high fever, with Stevens–Johnson syndrome and toxic epidermal necrolysis symptoms and intrahepatic cholestasis. Because 3 d of corticosteroid treatment did not alleviate the skin damage, double plasma molecular adsorption system (DPMAS) therapy was initiated, with treatment intervals of 48 h. Her skin symptoms improved gradually and were completely resolved after seven DPMAS treatments.
