A New Therapeutic Strategy for Streptococcal Toxic Shock Syndrome: A Key Target for Cytokines

Takayuki KAWAGUCHI; Naoya IGAKI; Sinichi KINOSHITA; Tomokazu MATSUDA; Aritoshi KIDA; Rintarou MORIGUCHI; Makoto SAKAI; Fumihiko TAMADA; Munetada OIMOMI; Takeo GOTO

doi:10.2169/internalmedicine.42.211

Takayuki KAWAGUCHI, Naoya IGAKI, Sinichi KINOSHITA, Tomokazu MATSUDA, Aritoshi KIDA, Rintarou MORIGUCHI, Makoto SAKAI, Fumihiko TAMADA, Munetada OIMOMI, Takeo GOTO

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Takayuki KAWAGUCHI
The Department of Internal Medicine, Takasago Municipal Hospital
Naoya IGAKI
The Department of Internal Medicine, Takasago Municipal Hospital
Sinichi KINOSHITA
The Department of Internal Medicine, Takasago Municipal Hospital
Tomokazu MATSUDA
The Department of Internal Medicine, Takasago Municipal Hospital
Aritoshi KIDA
The Department of Internal Medicine, Takasago Municipal Hospital
Rintarou MORIGUCHI
The Department of Internal Medicine, Takasago Municipal Hospital
Makoto SAKAI
The Department of Internal Medicine, Takasago Municipal Hospital
Fumihiko TAMADA
The Department of Internal Medicine, Takasago Municipal Hospital
Munetada OIMOMI
The Department of Internal Medicine, Takasago Municipal Hospital
Takeo GOTO
The Department of Internal Medicine, Takasago Municipal Hospital

Keywords: continuous hemodiafiltration, direct hemoperfusion, polymyxin B-immobilized fiber, plasma exchange, inflammatory cascade

JOURNAL FREE ACCESS

2003 Volume 42 Issue 2 Pages 211-218

DOI https://doi.org/10.2169/internalmedicine.42.211

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Abstract

We searched for innovative treatments specifically targeted to the cytokines of three critically ill patients with streptococcal toxic shock syndrome (STSS). Direct hemoperfusion with polymyxin B-immobilized fiber improved the hemodynamicsin all three patients whohad developed shock at presentation. Continuous hemodiafiltration coupled with plasma exchange for simultaneous removal of several mediators of the inflammatory cascade improved outcome in case 2 and lessened the aggressive clinical course and prolonged survival in case 3. The application of these technologies appears to open new and interesting therapeutic options and may lead to improved survival in STSS.
(Internal Medicine 42: 211-218, 2003)

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