Clinical Research of Severe Drug Eruption with Combined Different Dose Intravenous Immunoglobulin and Glucocorticoid

Objective To assess the therapeutic effect of severe drug eruption （including erythema multiforme drug eruption, drug-induced bullosaepidermolysis and drug-induced exfoliative dermatitis）with combined different dose intravenous immunoglobulin and glucocorticoid． Methods 32（group 1） and 36 （group 2） cases were carried out by mid-dose 0.2 g/（kg∙d）,high-dose 0.4 g/（kg∙d） intravenous immunoglobulin for 5 days respectively,and combined glucorticoid 0.8~1 mg/（kg·d）. 30（group 3） cases were treated with glucorticoid alone. The dose of glucorticoid hormone was reduced according to improving of disease condition. Obvervational index were defervescence time, deflorescence time, hospitalization days and adverse reaction. Statistic method was analysis of variance. Results Defervescence time, deflorescence time and hospitalization days of mid-dose, high-dose intravenous immunoglobulin and control group were （2.29±2.69）d, （2.16±1.98）d, （3.98±2.71）d（group 1 vs. group 3: Q=3.824, P<0.01; group 2 vs. group 3: Q=3.234,P<0.01;group 1 vs. group 2: Q=0.308,P>0.05）;（2.97±2.75） d, （2.46±0.96） d, （4.21±1.28） d（group 1 vs. group 3: Q=3.794,P<0.01; group 2 vs. group 3: Q=3.794,P<0.01; group 1 vs. group 2: Q=3.794,P<0.01）;（21.58±11.18） d, （20.16±9.29） d, （26.96±23.26）d（F=1.145, P=0.335）, three groups had no statistic difference respectively. There were five cases of IVIg adverse reaction slightly, including group 1 had one case and group 2 had four cases. Incidence was 7.35%（5/68）. Conclusion Our data indicated that combination therapy of corticosteroids and IVIg achieved a better therapeutic effect than the administration of corticosteroids alone. Combination therapy of corticosteroids and mid-dose IVIg was better choice for patients with severe underlying disease.