This study describes the efficacy of
plasmapheresis for the treatment of
toxic epidermal necrolysis (TEN), as reported in Japan. TEN patients treated with
plasmapheresis were collected from Japanese literature. The type of
plasmapheresis, number of sessions, efficacy of
plasmapheresis, and present outcome were examined. Forty-seven TEN patients treated with
plasmapheresis have been reported in the literature: 19 men and 28 women with ages ranging from 1 to 96 years (mean 50.3 years). Twenty-five of these treatments included simple
plasma exchange (PE), 13 included
double filtration plasmapheresis (DFPP), and one included PE and DFPP. The number of
plasmapheresis sessions ranged from 1 to 6 and the mean number of sessions was 3.1. The efficacy of
plasmapheresis for the treatment of TEN was as follows: excellent, 30 cases; good, 8 cases; fair, 3 cases; no effect, 5 cases; and unknown, 1 case. The rate of effectiveness was 80.9%; eleven patients died; and the mortality rate was 23.4%. In summary,
plasmapheresis, including both PE and DFPP, were found to be effective treatments for Japanese patients with TEN, who had been unresponsive to
corticosteroids, and for those who show severe clinical manifestations.