{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:20:47Z","timestamp":1783574447456,"version":"3.55.0"},"reference-count":28,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,12,1]]},"abstract":"<jats:p>Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis are the most severe cutaneous reactions that occur in children. Off-label use of human intravenous immunoglobulin (IVIG) has been reported in a number of autoimmune and cell-mediated blistering disorders of the skin, including severe cutaneous drug reactions. We review 28 previous reports in which IVIG was used in pediatric patients with SJS and toxic epidermal necrolysis and discuss our experience in 7 children with SJS, in whom no new blisters developed within 24 to 48 hours after IVIG administration and rapid recovery ensued. IVIG seems to be a useful and safe therapy for children with severe cutaneous drug reactions. Well-controlled, prospective, multicenter clinical trials are needed to determine optimal dosing guidelines and to compare the efficacy and safety of IVIG with other potentially effective modalities.<\/jats:p>","DOI":"10.1542\/peds.112.6.1430","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:43:47Z","timestamp":1092444227000},"page":"1430-1436","source":"Crossref","is-referenced-by-count":111,"title":["Use of Intravenous Immunoglobulin in Children With Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Seven Cases and Review of the Literature"],"prefix":"10.1542","volume":"112","author":[{"given":"Denise W.","family":"Metry","sequence":"first","affiliation":[{"name":"Departments of Dermatology"},{"name":"Pediatrics, Texas Children\u2019s Hospital, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Jung","sequence":"additional","affiliation":[{"name":"Departments of Dermatology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moise L.","family":"Levy","sequence":"additional","affiliation":[{"name":"Departments of Dermatology"},{"name":"Pediatrics, Texas Children\u2019s Hospital, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2003,12,1]]},"reference":[{"key":"2021121003453233400_R1","doi-asserted-by":"crossref","unstructured":"Roujeau JC, Stern RS. Severe adverse cutaneous reactions to drugs. N Engl J Med.1994;331:1272\u20131285","DOI":"10.1056\/NEJM199411103311906"},{"key":"2021121003453233400_R2","doi-asserted-by":"crossref","unstructured":"Becker DS. Toxic Epidermal Necrolysis. Lancet.1998;351:1417\u20131420","DOI":"10.1016\/S0140-6736(97)11369-1"},{"key":"2021121003453233400_R3","doi-asserted-by":"crossref","unstructured":"Huff JC, Weston WL, Tonnesen MG. Erythema multiforme: a critical review of characteristics, diagnostic criteria, and causes. J Am Acad Dermatol.1983;8:763\u2013765","DOI":"10.1016\/S0190-9622(83)80003-6"},{"key":"2021121003453233400_R4","doi-asserted-by":"crossref","unstructured":"Garcia-Doval I, LeCleach L, Bocquet H, et al. Toxic epidermal necrolysis and Stevens-Johnson syndrome: does early withdrawal of causative drugs decrease the risk of death?Arch Dermatol.2000;136:323\u2013327","DOI":"10.1001\/archderm.136.3.323"},{"key":"2021121003453233400_R5","unstructured":"Patterson R, Miller M, Kaplan M, et al. Effectiveness of early therapy with corticosteroids in Stevens-Johnson syndrome: experience with 21 cases and a hypothesis regarding pathogenesis. Ann Allergy.1994;73:27\u201334"},{"key":"2021121003453233400_R6","doi-asserted-by":"crossref","unstructured":"Ting HC, Adam BA. Erythema multiforme\u2014response to corticosteroids. Dermatologica.1984;169:175\u2013178","DOI":"10.1159\/000249598"},{"key":"2021121003453233400_R7","doi-asserted-by":"crossref","unstructured":"Halebian PH, Corder VJ, Madden MR, et al. Improved burn center survival of patients with toxic epidermal necrolysis managed without corticosteroids. Ann Surg.1986;204:503\u2013512","DOI":"10.1097\/00000658-198611000-00001"},{"key":"2021121003453233400_R8","doi-asserted-by":"crossref","unstructured":"Special symposium. Corticosteroids for erythema multiforme?Pediatr Dermatol.1989;6:229\u2013250","DOI":"10.1111\/j.1525-1470.1989.tb00824.x"},{"key":"2021121003453233400_R9","doi-asserted-by":"crossref","unstructured":"Colsky AS. Intravenous immunoglobulin in autoimmune and inflammatory dermatoses. A review of proposed mechanisms of action and therapeutic applications. Dermatol Clin.2000;18:447\u2013457","DOI":"10.1016\/S0733-8635(05)70193-5"},{"key":"2021121003453233400_R10","doi-asserted-by":"crossref","unstructured":"Rutter A, Luger TA. High-dose intravenous immunoglobulins: an approach to treat severe immune-mediated and autoimmune diseases of the skin. J Am Acad Dermatol.2001;44:1010\u20131024","DOI":"10.1067\/mjd.2001.112325"},{"key":"2021121003453233400_R11","doi-asserted-by":"crossref","unstructured":"Schwartz SA. Intravenous immunoglobulin treatment of immunodeficiency disorders. Pediatr Clin N Am.2000;47:1355\u20131369","DOI":"10.1016\/S0031-3955(05)70275-3"},{"key":"2021121003453233400_R12","doi-asserted-by":"crossref","unstructured":"Viard I, Wehrli P, Bullani R, et al. Inhibition of toxic epidermal necrolysis by blockade of CD95 with human intravenous immunoglobulin. Science.1998;282:490\u2013493","DOI":"10.1126\/science.282.5388.490"},{"key":"2021121003453233400_R13","unstructured":"Amato GM, Travia A, Ziino O. The use of intravenous high-dose immunoglobulins (IVIG) in a case of Stevens-Johnson syndrome. Pediatr Med Chir.1992;14:555\u2013556"},{"key":"2021121003453233400_R14","doi-asserted-by":"crossref","unstructured":"Moudgil A, Porat S, Brunnel P, et al. Treatment of Stevens-Johnson syndrome with pooled human intravenous immuneglobulin. Clin Pediatr.1995;34:48\u201351","DOI":"10.1177\/000992289503400109"},{"key":"2021121003453233400_R15","doi-asserted-by":"crossref","unstructured":"Magina S, Lisboa C, Goncalves E, et al. A case of toxic epidermal necrolysis treated with intravenous immunoglobin. Br J Dermatol.2000;142:191\u2013192","DOI":"10.1046\/j.1365-2133.2000.03276.x"},{"key":"2021121003453233400_R16","unstructured":"Morici MV, Galen WK, Shetty AK, et al. Intravenous immunoglobulin therapy for children with Stevens-Johnson syndrome. J Rheumatol.2000;27:2494\u20132497"},{"key":"2021121003453233400_R17","doi-asserted-by":"crossref","unstructured":"Straussberg R, Harel L, Ben-Amitai D, et al. Carbamazepine-induced Stevens-Johnson syndrome treated with IV steroids and IVIG. Pediatr Neurol.2000;22:231\u2013233","DOI":"10.1016\/S0887-8994(99)00137-X"},{"key":"2021121003453233400_R18","doi-asserted-by":"crossref","unstructured":"Tristani-Firouzi P, Petersen MF, Saffle JR, et al. Treatment of toxic epidermal necrolysis with intravenous immunoglobulin in children. J Am Acad Dermatol.2002;47:548\u2013552","DOI":"10.1067\/mjd.2002.127249"},{"key":"2021121003453233400_R19","doi-asserted-by":"crossref","unstructured":"Samimi SS, Siegfried E. Stevens-Johnson syndrome developing in a girl with systemic lupus erythematosus on high-dose corticosteroid therapy. Pediatr Dermatol.2002;19:52\u201355","DOI":"10.1046\/j.1525-1470.2002.00002.x"},{"key":"2021121003453233400_R20","doi-asserted-by":"crossref","unstructured":"Prins C, Kerdel FA, Padilla RS, et al. Treatment of toxic epidermal necrolysis with high-dose intravenous immunoglobulins: multicenter retrospective analysis of 48 consecutive cases. Arch Dermatol.2003;139:26\u201332","DOI":"10.1001\/archderm.139.1.26"},{"key":"2021121003453233400_R21","doi-asserted-by":"crossref","unstructured":"Bachot N, Revuz J, Roujeau JC. Intravenous immunoglobulin treatment for Stevens-Johnson syndrome and toxic epidermal necrolysis: a prospective noncomparative study showing no benefit on mortality or progression. Arch Dermatol.2003;139:33\u201336","DOI":"10.1001\/archderm.139.1.33"},{"key":"2021121003453233400_R22","doi-asserted-by":"crossref","unstructured":"Paul C, Wolkenstein P, Adle H, et al. Apoptosis as a mechanism of keratinocyte death in toxic epidermal necrolysis. Br J Dermatol.1996;134:710\u2013714","DOI":"10.1111\/j.1365-2133.1996.tb06976.x"},{"key":"2021121003453233400_R23","doi-asserted-by":"crossref","unstructured":"Roujeau JC. The spectrum of Stevens-Johnson syndrome and toxic epidermal necrolysis: a clinical classification. J Investig Dermatol.1994;102:28S\u201330S","DOI":"10.1111\/1523-1747.ep12388434"},{"key":"2021121003453233400_R24","doi-asserted-by":"crossref","unstructured":"Bastuji-Garin S, Rzany B, Stern RS, et al. Clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome, and erythema multiforme. Arch Dermatol.1993;129:92\u201396","DOI":"10.1001\/archderm.129.1.92"},{"key":"2021121003453233400_R25","doi-asserted-by":"crossref","unstructured":"Dibirdik I, Durak N, Kislaoglu E, et al. Effects of prophylactic intravenous immunoglobulin-G therapy on humoral and cellular immune components and their functions in burned patients. Burns.1995;21:130\u2013135","DOI":"10.1016\/0305-4179(95)92138-3"},{"key":"2021121003453233400_R26","doi-asserted-by":"crossref","unstructured":"Kazatchkine MD, Kaveri SV. Immunomodulation of autoimmune and inflammatory disease with intravenous immune globulin. N Engl J Med.2001;345:747\u2013755","DOI":"10.1056\/NEJMra993360"},{"key":"2021121003453233400_R27","doi-asserted-by":"crossref","unstructured":"Dwyer JM. Manipulating the immune system with immune globulin. N Engl J Med.1992;326:107\u2013116","DOI":"10.1056\/NEJM199201093260206"},{"key":"2021121003453233400_R28","doi-asserted-by":"crossref","unstructured":"Fasano MB. Risks and benefits of intravenous immunoglobulin treatment in children. Curr Opin Pediatr.1995;7:688\u2013694","DOI":"10.1097\/00008480-199512000-00011"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/112\/6\/1430\/1102499\/zpe01203001430.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/112\/6\/1430\/1102499\/zpe01203001430.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T10:58:36Z","timestamp":1639133916000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/112\/6\/1430\/63526\/Use-of-Intravenous-Immunoglobulin-in-Children-With"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,12,1]]},"references-count":28,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2003,12,1]]},"published-print":{"date-parts":[[2003,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.112.6.1430","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,12,1]]}}}