Modern experience of treating Lyell's syndrome in children

Lyell's syndrome is a severe polyetiological disease of allergic nature, characterized by sharp violation General state of the patient, bullous lesions throughout the skin and mucous membranes.
It received its main name in honor of the doctor Lyell, who first described in 1956 as a severe form of toxicoderma. This syndrome in subsequent years tends to increase among all age groups (including infants), due to the widespread use of chemotherapy among all age groups.
The most common causes of Lyell's syndrome are sulfonamides, antibiotics (especially penicillin, streptomycin and tetracyclines), salicylic acid derivatives, pyrazolone, barbiturates, dysentery bacteriophage, anti-tetanus serum. It is especially dangerous to use “therapeutic cocktails”, consisting of a mixture of different drugs, usually antibiotics, sulfonamides, anti-inflammatory, anti-pyrexic drugs.
Lyell's syndrome is a rare disease. At any age, most often in people aged 20-40 years , earlier children occur during the first three years of life. Lyell's syndrome is a total frequency of 0.4 to 1.2 cases per 1 million population, found in 0.3% of cases of drug Allergy. According to various data, mortality in Lyell's syndrome ranges from 30% to 70%, since Lyell's syndrome from severe course in 30-50% of patients there is a risk of death within 5-30 days from the date of the disease. Seasonal increase of the disease is recorded in the winter day and early spring. In the treatment of the disease and possible re-disease. In the literature there are few publications on this topic and on modern methods of treatment.
The prognosis of the disease is determined by the nature of its course. In this regard, there are 3 variants of the course of Lyell's syndrome: acute lethal outcome, lethal outcome at the confluence of an acute infectious process and, as a rule, favorable after 7-10 days of treatment. Early start of therapeutic measures and their careful implementation improve the prognosis of the disease. This syndrome is one of the most important topics in medicine, it is considered as an autoimmune, autoallergic disease in pathogenesis.

1. Anesteziologija i intensivnaja terapija: Prakticheskoe rukovodstvo / red. Gel'fand B.R. - M. : Litterra, 2006. - 576 s.

2. Anesteziologija : per. s nem. / red. Rajner Shefer . - M. : GJeOTAR-Media, 2009.

3. Gel'fand B. R. Intensivnaja terapija. Nacional'noe rukovodstvo 1-2 tom. GZTOAR. 2009.

4. Gordeev V. I. Pediatricheskaja anesteziologija-reanimatologija : Chastnye razdely / Gordeev V. I., Aleksandrovich Ju.S. - SPb. : SPb med.izd., 2004. - 409 s.

5. Zhernosek V.F., T.P. Djubkova. Sindrom Stivensa—Dzhonsona — toksicheskij jepidermal'nyj nekroliz u detej. Belorusskaja medicinskaja akademija poslediplomnogo obrazovanija, Belorusskij gosudarstvennyj universitet. Zhurnal «Medicinskie novosti» №14, 2007.

6. Sindrom Lajella kak redkoe oslozhnenie medikamentoznoj terapii (klinicheskie sluchai)/Tezjaeva S. A., Mlinnik R. A., Degtjareva S. F., Vagapova T. V, Nikol'skij V. O.// MediAl. - 2015 - №2 (16).

7. Toғajbaev A. A. Reanimatologija zhәne қarқyndy emdeu : Oқu құraly / Toғajbaev A. A., Mұrathanov E. Zh. - Almaty : Asem-sistem, 2003. - 496 b.