Double plasma molecular adsorption system for Stevens-Johnson syndrome/toxic epidermal necrolysis: A case report

World J Clin Cases. 2024 Mar 6;12(7):1371-1377. doi: 10.12998/wjcc.v12.i7.1371.

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.

Keywords: COVID-19; Case report; Double plasma molecular adsorption system; SARS-CoV-2; Stevens-Johnson; Toxic epidermal necrolysis.

Publication types

  • Case Reports