Da Woon Sim1,2, Ji Eun Yu1, Jiung Jeong1, Jae-Woo Jung3, Hye-Ryun Kang4, Dong Yoon Kang4, Young Min Ye5, Young-Koo Jee6, Sujeong Kim7, Jung-Won Park2, Min Gyu Kang8, Sae Hoon Kim9, Hye-Kyung Park10, Min-Suk Yang11, Gyu-Young Hur12, Jun Kyu Lee13, Jeong-Hee Choi14, Yong Eun Kwon15, Young-Il Koh1. 1. Division of Allergy, Asthma and Clinical Immunology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. 2. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. 3. Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea. 4. Drug Safety Monitoring Center, Seoul National University Hospital, Seoul, Korea. 5. Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea. 6. Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea. 7. Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea. 8. Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea. 9. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. 10. Department of Internal Medicine, Pusan National University Hospital, Busan, Korea. 11. Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea. 12. Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. 13. Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea. 14. Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea. 15. Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea.
Abstract
PURPOSE: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but serious condition that systematically damages various internal organs through T-cell-mediated immunological drug reactions. We aimed to investigate whether clinical manifestations of DRESS syndrome differ according to culprit drugs. METHODS: We retrospectively analyzed data from 123 patients with probable/definite DRESS syndrome based on the RegiSCAR criteria (January 2011 to July 2016). The data were obtained from the Korean Severe Cutaneous Adverse Reaction Registry. Causality was assessed using the World Health Organization-Uppsala Monitoring Centre criteria. The culprit drugs were categorized as allopurinol, carbamazepine, anti-tuberculosis drug, vancomycin, cephalosporins, dapsone, and nonsteroidal anti-inflammatory drugs. RESULTS: Differences were observed among culprit drugs regarding the frequencies of hepatitis (P < 0.01), renal dysfunction (P < 0.0001), lymphadenopathy (P < 0.01), and atypical lymphocyte (P < 0.01). Latency period differed among culprit drugs (P < 0.0001), being shorter in vancomycin and cephalosporin. In terms of clinical severity, admission duration (P < 0.01) and treatment duration (P < 0.05) differed among culprit drugs, being longer in vancomycin and anti-tuberculosis drugs, respectively. CONCLUSIONS: Based on the findings, clinical manifestations, including latency period and clinical severity, may differ according to culprit drugs in DRESS syndrome.
PURPOSE:Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but serious condition that systematically damages various internal organs through T-cell-mediated immunological drug reactions. We aimed to investigate whether clinical manifestations of DRESS syndrome differ according to culprit drugs. METHODS: We retrospectively analyzed data from 123 patients with probable/definite DRESS syndrome based on the RegiSCAR criteria (January 2011 to July 2016). The data were obtained from the Korean Severe Cutaneous Adverse Reaction Registry. Causality was assessed using the World Health Organization-Uppsala Monitoring Centre criteria. The culprit drugs were categorized as allopurinol, carbamazepine, anti-tuberculosis drug, vancomycin, cephalosporins, dapsone, and nonsteroidal anti-inflammatory drugs. RESULTS: Differences were observed among culprit drugs regarding the frequencies of hepatitis (P < 0.01), renal dysfunction (P < 0.0001), lymphadenopathy (P < 0.01), and atypical lymphocyte (P < 0.01). Latency period differed among culprit drugs (P < 0.0001), being shorter in vancomycin and cephalosporin. In terms of clinical severity, admission duration (P < 0.01) and treatment duration (P < 0.05) differed among culprit drugs, being longer in vancomycin and anti-tuberculosis drugs, respectively. CONCLUSIONS: Based on the findings, clinical manifestations, including latency period and clinical severity, may differ according to culprit drugs in DRESS syndrome.
Authors: A Chaabane; H Ben Romdhane; N Ben Fadhel; N Ben Fredj; H Ammar; N Boughattas; Z Chadly; K Aouam Journal: Eur J Clin Pharmacol Date: 2022-06-20 Impact factor: 3.064