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Stevens-Johnson syndrome with cicatrising conjunctivitis, treated with daclizumab: 4 patients Three girls and one boy aged 4–14 years* developed Stevens-Johnson syndrome (SJS) with cicatrising conjunctivitis following treatment with dipyrone, phenytoin or an unspecified sulfonamide [see table]. They were included in an interventional study evaluating daclizumab treatment. Symptoms of SJS-associated cicatrising conjunctivitis were refractory to corticosteroids and immunomodulators. Therapy was commenced with IV daclizumab 1 mg/kg in five divided doses at 2-week intervals, followed by two further cycles administered at 3-week and 4-week intervals, respectively. Patients 1 and 3 developed gastric discomfort following the first daclizumab infusion, but symptoms resolved within 2 days. Control of ocular inflammation was achieved within 6–10 weeks of daclizumab therapy. During maintenance therapy, patient 1 experienced two episodes of recurrent ocular inflammation. Symptoms resolved with topical corticosteroids on both occasions.

Patient characteristics Druga

SJS type

BCVA

Inflamm. gradingb

1/F/4

Dipyrone

SJS-RI

2/M/14

Phenytoin

3/F/10

Sulfonamide

SJS-RI, SJS-OSF SJS-RI

4/F/10

Phenytoin

CF (R) LP (L) HM (R) HM (L) HM (R) CF (L) 20/40 (R) 20/100 (L)

2.5+ 4+ 4+ 4+ 3.5+ 2.5+ 2.5+ 2.5+

Patient/ sex/ age (y)

SJS-RI

SJS-RI, Stevens Johnson syndrome- recurrent inflammation; SJS-OSF, Stevens Johnson syndrome- ocular surface failure; BCVA, best corrected visual acuity; R, right eye; L, left eye; CF, counting fingers; LP, light perception; HM, hand motion; Inflamm, inflammation. a routes, dosages, indications and times to reactions onset not stated. b conjunctival and scleral inflammation grading (0–4, in 0.5 scale), prior to starting daclizumab.

* an additional patient was included in the study, but the cause of SJS was unknown. Fiorelli VMB, et al. Systemic monoclonal antibody therapy (Daclizumab) in the treatment of cicatrizing conjunctivitis in stevens-johnson syndrome, refractory to conventional therapy. Current Eye Research 35: e1057-1062, No. 12, Dec 2010. Available from: URL: http://dx.doi.org/10.3109/02713683.2010.511392 803048390 USA

0114-9954/10/1336-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved

Reactions 29 Jan 2011 No. 1336