Abstract
A 34-year-old male was diagnosed with Stevens-Johnson syndrome (SJS) after taking an over-the-counter drug containing ibuprofen. Systemic administration of high-dose corticosteroids failed to improve his clinical manifestations, and subsequently toxic epidermal necrolysis (TEN) developed. Daily plasma exchange (PE) was performed for five days. The replacement fluids were fresh frozen plasma for the first session. The remaining four sessions were selective PE employing Evacure® EC-4A as a membrane separator. Evacure® EC-4A theoretically removes small molecules, some of which are presumably implicated in the development of SJS/TEN, while eliminating relatively small amount of large molecules such as fibrinogen. Albumin was used as the replacement fluids for selective PE. PE and selective PE rapidly improved his mucocutaneous lesions. Selective PE using Evacure® EC-4A with albumin as a replacement fluid might be an effective therapeutic modality and is expected to be superior to PE with fresh frozen plasma in the safety profiles and the cost-effectiveness.
