中毒性表皮壊死症 : 本邦のアフェレシス報告例の解析(<特集>皮膚難病とアフェレシス)

概要

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We described the analysis of toxic epidermal necrolysis (TEN) patients which were treated with plasmapheresis in Japan. TEN patients treated with plasmapheresis were collected from Japanese literature. The kind of plasmapheresis, number of sessions, efficacy of plasmapheresis and present outcome, were examined. One hundred and seven TEN patients treated with plasmapheresis have been reported in the literature. The 107 consisted of 43 men and 64 women with ages ranging from 1 to 96 years (mean 55.3 years). Seventy-two of these included simple plasma exchange (PE), 21 of these included double filtration plasmapheresis (DFPP), and 4 of these included PE and DFPP. The number of plasmapheresis sessions ranged from 1 to 16 and the mean number of sessions was 3.6. The efficacy of plasmapheresis for the treatment of TEN was as follows: excellent 71 cases, good 23 cases, fair 5 cases, no effect 7 cases and unknown 1 case. The rate of effectiveness was 87.9%. Eighteen of these patients died. The mortality rate was 16.8%. As a conclusion, plasmapheresis including both PE and DFPP were found to be effective treatments for the TEN patients who had been unresponsive to corticosteroids and for those who showed severe clinical manifestations, in Japan.
2013-05-31