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Table 1 Literature of TEN causes (case series of five or more pediatric patients 2009–2015)

From: Warfarin-induced toxic epidermal necrolysis in combination therapy of Henoch-Schönlein purpura nephritis: a case report

Author (year)

Number of pediatric patients

Age (years)

SCORTEN (mean ± SD)

BSA affected (%; mean ± SD)

Rash days from drug intake (days)

Etiology (%)

LTT

Treatment (%)

Outcome

Quirke et al. (2015) [7]

N = 41 (BSA > 30%: n = 23, BSA ≤ 30%; n = 16, unknown; n = 2:)

11.2 ± 4.6

1.4 ± 0.7

39.7 ± 26.0

ND

Drugs (90%: anticonvulsants, antibiotics, NSAIDS, others), mycoplasma pneumoniae (5%), unknown (5%)

ND

Corticosteroids (54%), IVIG (17%), supplemental nutritional support (90%), required mechanical ventilation (51%)

Mortality

(0%)

Hamilton et al. (2013) [8]

N = 10 (BSA 20–30%: n = 4, BSA > 30%: n = 4, unknown: n = 2)

6.6 ± 3.9

1.7 ± 0.5

42.2 ± 20.6

ND

Drugs (70%: anticonvulsants, antibiotics, others), mycoplasma infection (20%), unknown (10%)

ND

IVIG (80%), corticosteroids (20%), antibiotics (60%)

Mortality

(0%)

Finkelstein et al. (2011) [9]

N = 55 (TEN: n = 5, SJS: n = 47, SJS/TEN: n = 3)

9.6 ± 4.8

ND

ND

ND

Drugs (anticonvulsants: 29%, antibiotics: 20%, chemotherapy drugs: 2%), infections (mycoplasma pneumonia: 22%, herpes simplex virus: 9%), undetermined (18%)

NDa

Supportive care (100%), antibiotics (67%), antiviral (38%), corticosteroids (40%), IVIG (38%), corticosteroids plus IVIG (14%)

Mortality

(2%)

Ferradiz et al. (2011) [10]

N = 14 (TEN: n = 6, SJS: n = 8)

10.4 (range: 1–17)

ND

60 (range: 10–96)

16.5 (1–30)

Suspicious drugs (anticonvulsants: 50%, antiviotics: 36%, NSAIDS: 21%)

ND

Supportive care (100%), corticosteroids: 1-2 mg/kg/day, 9 days (86%), IVIG: 1-2 g/kg/day, 3 days (29%), silversulfadiazine dressings (71%)

Mortality (7%)

Levi et al. (2009) [1]

N = 80 (TEN: n = 27, SJS: n = 21, SJS/TEN: n = 32)

6.2 (IQR: 3.7–9.9)

ND

20 (range: 10–40)

6 (range; 1–17)b

Drugs (anticonvulsants: 30%, antiviotics: 40%, others), mycoplasma pneumoniae (9%)

ND

ND

Mortality (7.5%)

  1. We excluded reports describing <10 patients, and those that did not provide data about causative drugs or treatments
  2. All reports published between 2009 and 2015 in English describing TEN in children were retrieved using MEDLINE
  3. Abbreviations: BSA body surface area, SCORTEN Score of Toxic Epidermal necrolysis, ND no data, TEN Toxic Epidermal Necrolysis, SJS Stevens-Johnson Syndrome, LTT lymphocyte transformation test, IQR interquartile range, NSAID nonsteroidal anti-inflammatory drugs
  4. a15 children underwent skin biopsies
  5. bDays between acetaminophen initiation and onset of disease