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August 2003

Intravenous Immunoglobulin for the Treatment of Toxic Epidermal Necrolysis

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Arch Dermatol. 2003;139(8):1081. doi:10.1001/archderm.139.8.1081-a

We would like the opportunity to respond to the comments by Wolff and Tappeiner1 regarding the lack of information on the brands of intravenous immunoglobulin (IVIG) used in our study2 to treat 16 patients with toxic epidermal necrolysis (TEN). Six patients received Immune Globulin 10 (Bayer), 6 Gamimmune (Bayer), 2 Gammar P (Bayer), 1 Polygam (American Red Cross), and 1 received both Gamimmune and Gammar P (2 doses of each). Our only fatality, a patient who died of a myocardial infarction after her TEN had resolved, had been treated with Gammar P IVIG. While we did not test each batch of IVIG for Fas-FasL activity, in retrospect, the different brands of IVIG did not appear to make any difference in the clinical outcome.

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