Clinical Parameters and Biological Markers associated with Acute Severe Ocular Complications in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Thailand

Abstract

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions with high mortality rates. Sequelae such as blindness remained even after recovery. Patients with SJS/TEN should be accurately diagnosed and received appropriate treatment as soon as possible. Therefore, factors for severity prediction are necessary. This study aimed to clarify clinical parameters and biological markers that can predict acute severe ocular complications (SOCs) in SJS/TEN. This retrospective cross-sectional study enrolled forty-seven SJS/TEN patients and divided them into two groups according to ocular severity at the acute onset, non-severe ocular complications group (N = 27) and severe ocular complications group (N = 20). Multivariate logistic regression analysis revealed that the disease severity (body surface area detachment ≥ 10%) was identified as a predictive factor for acute SOCs, and older age (≥ 60 years) is marginally significantly as predicting SOCs. When compare biomarkers levels in serum of non-severe and severe ocular complications in SJS/TEN patients, S100A8/A9, and granulysin are marginally significant and tend to increase in the SOCs group. During the early acute stage, focusing on the disease severity, patients' age, and inflammatory biomarkers, i.e., S100A8/A9 and granulysin, might be the predictive factors for the progression of SOCs in SJS/TEN patients who need prompt aggressive ocular management to prevent severe ocular sequelae.