Serum interleukin-21 level in patients with severe adverse cutaneous drug reactions and correlation with disease severity

Abstract

Introduction Interleukin-21 (IL-21) is accepted to play a pathogenic part in development of unfavorable cutaneous medicate responses. Adverse cutaneous drug reactions create a wide run of clinical signs such as pruritus, maculopapular ejections, urticaria, angioedema, fixed drug eruption, erythema multiforme, vesiculobullous responses (e.g. Stevens–Johnson syndrome and toxic epidermal necrolysis), and exfoliative dermatitis. Patients and methods Twenty patients (drug-eruption group) and 14 healthy controls (control group) were recruited from Assiut University Hospitals' Dermatology Department and Outpatient Clinic. Data were collected in the period from October 2017 to December 2018. Patients were assessed clinically by percentage of surface area of the body involvement (body surface area %) and score of toxic epidermal necrolysis. At presentation and after 1 month of treatment, blood samples were taken to evaluate serum IL-21 levels using an enzyme-linked immunosorbent assay. Results Inside the study, the cruel serum IL-21 level was considerably greater than in the control group, in drug-eruption group was 575.58 ± 94.67 ng/dl, and in the control group was 128.00 ± 73.94 ng/dl with P value of 0.000. The drug-eruption group had a significantly higher serum level of IL-21 before treatment than after treatment with P value of 0.000. Additionally, there was a critical relationship between IL-21 levels in the blood and the severity of the condition. Before and after therapy, there was a significant positive association between blood IL-21 levels and the proportion of body surface area involvement. Conclusion IL-21 levels in the blood were significantly higher in EM and SJS/TEN patients, suggesting that it may have a role in the etiology of EM and SJS/TEN and it could be employed as a marker for the severity of SJS/TEN and patient prognosis in the future.