Clinical features of drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome: a study of 25 patients in Korea

Background Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare adverse drug reaction. This study aimed to evaluate the incidence of association with individual drugs, clinical manifestations, disease course, and outcomes of DRESS. Methods Using the criteria of the Europe...

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Bibliographic Details
Published in:	International journal of dermatology Vol. 56; no. 9; pp. 944 - 951
Main Authors:	Lee, Jin Y., Lee, Suh‐Young, Hahm, Ji E., Ha, Jae W., Kim, Chul W., Kim, Sang S.
Format:	Journal Article
Language:	English
Published:	England Blackwell Publishing Ltd 01-09-2017
Subjects:	Abnormalities Adolescent Adult Aged Aged, 80 and over Allopurinol Allopurinol - adverse effects Anticonvulsants Anticonvulsants - administration & dosage Anticonvulsants - adverse effects Antitubercular Agents - adverse effects Carbamazepine Carbamazepine - adverse effects Correlation analysis Demographics Drug Hypersensitivity Syndrome - blood Drug Hypersensitivity Syndrome - drug therapy Drug Hypersensitivity Syndrome - etiology Drugs Eosinophilia Eosinophilia - blood Female Glucocorticoids - therapeutic use Gout Suppressants - adverse effects Humans Immunoglobulins, Intravenous - therapeutic use Immunologic Factors - therapeutic use Incidence Latency Male Medical records Men Methylprednisolone - therapeutic use Middle Aged Patients Prednisone - therapeutic use Republic of Korea Retrospective Studies Severity of Illness Index Side effects Thrombocytopenia - blood Time Factors Young Adult
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Summary:	Background Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare adverse drug reaction. This study aimed to evaluate the incidence of association with individual drugs, clinical manifestations, disease course, and outcomes of DRESS. Methods Using the criteria of the European Registry of Severe Cutaneous Adverse Reactions (RegiSCAR), the medical records of 25 patients diagnosed with DRESS between 2006 and 2015 were retrospectively reviewed. Demographic data, culprit drugs, latency periods, clinical and laboratory findings, and outcomes were investigated. Results The study group comprised 11 men (44%) and 14 women (56%) with an age range of 13–93 years (mean, 58 ± 19.86 years). The drugs most commonly implicated were carbamazepine (28%), allopurinol (16%), and antituberculosis drugs (12%). Individual latency periods ranged from 4 to 40 days (mean, 17.6 ± 9.95 days). Latency periods for anticonvulsants were significantly longer than those for other drugs (P < 0.05). However, no statistical differences were found between the RegiSCAR scores for anticonvulsants and those for other drugs. Disease severity, based on RegiSCAR score, was correlated with blood count abnormalities (P < 0.05). Conclusions The results of our study revealed that anticonvulsants were the leading culprit drugs for DRESS, and carbamazepine was the individual drug most commonly associated with DRESS in Korea. Further studies of the mechanisms of action of these drugs are required in order to facilitate prompt diagnosis and effective management, which can affect prognosis and clinical outcome, of DRESS.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0011-9059 1365-4632
DOI:	10.1111/ijd.13667