I-Chun Lin1, Hung-Chih Yang2, Carol Strong3, Che-Wen Yang1, Yung-Tsu Cho1, Kai-Lung Chen1, Chia-Yu Chu4. 1. Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. 2. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Microbiology, National Taiwan University College of Medicine, Taipei, Taiwan. 3. Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 4. Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: chiayu@ntu.edu.tw.
Abstract
BACKGROUND: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a syndrome involving multiple systems. Liver injury is the most common visceral manifestation. OBJECTIVE: The purpose of this study was to investigate the types of liver injury and factors associated with DRESS. METHODS: A retrospective cohort study was conducted in Taiwan using a DRESS database compiled from December 2000 to March 2013. RESULTS: Seventy-two cases were included in this study. Among them, 62 (86.1%) cases involved liver injury, 6 of which (9.7%) were liver injury before skin presentation. The distribution of liver injury patterns at initial presentation was 23 cholestatic type (37.1%), 17 mixed type (27.4%), and 12 hepatocellular type (19.4%). Patients with hepatocellular-type injuries were younger, with a median age of 31.5 (P = .044). Individuals with liver function results more than 10 times the upper limit were more likely to have fever (P = .026), took more time to recover, and had fewer eosinophils in the dermis (P = .002). LIMITATIONS: The study was a retrospective cohort study with limited cases. CONCLUSIONS: Liver injury is common in DRESS and frequently associated with atypical lymphocytosis. The cholestatic type is the most common type. Patients with cholestatic-type injuries were older and more frequently had interface changes in skin pathology.
BACKGROUND:Drug reaction with eosinophilia and systemic symptoms (DRESS) is a syndrome involving multiple systems. Liver injury is the most common visceral manifestation. OBJECTIVE: The purpose of this study was to investigate the types of liver injury and factors associated with DRESS. METHODS: A retrospective cohort study was conducted in Taiwan using a DRESS database compiled from December 2000 to March 2013. RESULTS: Seventy-two cases were included in this study. Among them, 62 (86.1%) cases involved liver injury, 6 of which (9.7%) were liver injury before skin presentation. The distribution of liver injury patterns at initial presentation was 23 cholestatic type (37.1%), 17 mixed type (27.4%), and 12 hepatocellular type (19.4%). Patients with hepatocellular-type injuries were younger, with a median age of 31.5 (P = .044). Individuals with liver function results more than 10 times the upper limit were more likely to have fever (P = .026), took more time to recover, and had fewer eosinophils in the dermis (P = .002). LIMITATIONS: The study was a retrospective cohort study with limited cases. CONCLUSIONS:Liver injury is common in DRESS and frequently associated with atypical lymphocytosis. The cholestatic type is the most common type. Patients with cholestatic-type injuries were older and more frequently had interface changes in skin pathology.
Authors: Antonio Segovia-Zafra; Daniel E Di Zeo-Sánchez; Carlos López-Gómez; Zeus Pérez-Valdés; Eduardo García-Fuentes; Raúl J Andrade; M Isabel Lucena; Marina Villanueva-Paz Journal: Acta Pharm Sin B Date: 2021-11-18 Impact factor: 11.413
Authors: Benedetta Marigliano; Federico Rosa; Mattia Internullo; Luigi Scuro; Andrea Tavanti; Lucia Rita Del Vecchio; Francesco Paolo Romagno; Maria Barbara Schito; Federica Pace; Giovanni Maria Colombo; Emanuele Guglielmelli Journal: Eur J Case Rep Intern Med Date: 2022-07-14