Clinical parameters and biological markers associated with acute severe ocular complications in Stevens-Johnson syndrome and toxic epidermal necrolysis

Sci Rep. 2021 Oct 12;11(1):20275. doi: 10.1038/s41598-021-99370-1.

Abstract

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions with high mortality rates. Its sequelae, such as blindness, persist even after recovery. Patients with SJS/TEN should be accurately diagnosed and receive appropriate treatment as soon as possible. Therefore, identifying the factors for severity prediction is necessary. We aimed to clarify the clinical parameters and biological markers that can predict acute severe ocular complications (SOCs) in SJS/TEN. This retrospective cross-sectional study enrolled 47 patients with SJS/TEN who were divided into two groups according to ocular severity at acute onset: non-severe ocular complications group (n = 27) and severe ocular complications group (n = 20). Multivariate logistic regression analysis revealed that disease severity (body surface area detachment ≥ 10%) was a predictive factor for acute SOCs, and older age (≥ 60 years) was marginally significantly predictive of SOCs. Serum biomarker levels of S100A8/A9 and granulysin were marginally significant and tended to increase in the SOC group. Therefore, during the early acute stage, focusing on disease severity, patient age, and serum inflammatory biomarkers (S100A8/A9 and granulysin) might help predict SOC progression in patients with SJS/TEN who need prompt and aggressive ocular management to prevent severe ocular sequelae.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Antigens, Differentiation, T-Lymphocyte / blood*
  • Biomarkers / blood
  • Calgranulin A / blood*
  • Calgranulin B / blood*
  • Cross-Sectional Studies
  • Disease Progression
  • Eye Diseases / etiology
  • Eye Diseases / metabolism*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Patient Acuity
  • Retrospective Studies
  • Stevens-Johnson Syndrome / complications*

Substances

  • Antigens, Differentiation, T-Lymphocyte
  • Biomarkers
  • Calgranulin A
  • Calgranulin B
  • GNLY protein, human
  • S100A8 protein, human
  • S100A9 protein, human