| Objective: To evaluate the effect and safety of high dose intravenous immunoglobulin(IVIG) in toxic epidermal necrolysis(TEN).Methods: A retrospective analysis of 12 consecutive patients with TEN who were treated with IVIG. Retrospective cohort review of the records of all TEN patients admitted to Shandong Provincial Hospital Dermatology Department between January 1, 2000 and April 30, 2007. Of the 12 patients, 3 male and 9 female, aged from 3 to 64 (mean 37.7 yaers) , with skin detachment≥30% of their totle body surface(TBSA)[mean,63.7%;range,30%～90%] and 10 patients had mucous complications(83.3%). Infusion of IVIG (mean totle dose, 1.7g/kg[range,0.1～2.0g/kg] ) in all patients daily for 1～6 days( mean,4.8 days ) and observe the clinical response and final outcome.Results: The mean length of saty(LOS) was 21.3 days( range,2～42days ). 7 patients discharged after complete recovery(58.3%) and 1 patient dischargevoluntarily(8.3%). One patient died and the survival rate come to 91.7%. Infusion of IVIG was associate-d with a rapid cessationa( mean,4.8 days; range,2～7days ) of skin and mucosal detachment in 11 patients . The mean time to complete skin healing was 24.3 days(range, 17～40days ).Only 8 patients achieved complete mucous healing(66.7%) when discharged. Follow-up (1,2,4 weeks after discharging ) in 10 patients showed that 3 more patients obtained complete recovery 4 weeks after discharg- ing and no recurrence happened. 1 patient progressed symblepharon within 1 week after discharging and the others developped no any sequelae or complication of TEN.Conclusion: 1. Early treatment with combination of high-dose IVIG at a total dose of 2g/kg(0.4g/kg per day for 5 days or 0.5g/kg per day for 4 days) and glucocorticoids is a safe and effective therapeutic method for TEN.2. Patients' responsiveness to IVIG treatment is associated with several parameters.3. Any patient treated with IVIG should be adequately monitored for the development of complications.
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