SEVERE TOXIC EPIDERMAL NECROLYSIS COMPLICATED BY ACUTE KIDNEY INJURY: DIAGNOSTIC AND THERAPEUTIC CONSIDERATIONS

To present a rare case of toxic epidermal necrolysis complicated by acute kidney injury and to discuss diagnostic challenges and therapeutic decision-making, including early continuous renal replacement therapy.

We report a clinical case of a 56-year-old male with severe toxic epidermal necrolysis following trimethoprim-sulfamethoxazole exposure, complicated by acute kidney injury. Clinical, laboratory, and imaging data were analyzed in accordance with KDIGO criteria and current management guidelines.

The patient developed extensive epidermal detachment, mucosal involvement, and uremic biochemical abnormalities. Despite the absence of classic indications for dialysis, continuous renal replacement therapy was initiated early, allowing stabilization of metabolic parameters and safe administration of immunosuppressive therapy. Rapid clinical improvement and recovery of renal function were observed.

Concurrent toxic epidermal necrolysis and acute kidney injury represents a high-risk clinical scenario requiring early multidisciplinary intervention. Individualized treatment decisions, including early renal replacement therapy, may improve outcomes even in the absence of standard dialysis indications.