title: Drug reaction with eosinophilia and systemic symptoms: a retrospective study of 60 cases.
abstract: OBJECTIVE
  To investigate the clinical and pathologic features of patients with drug reaction with eosinophilia and systemic symptoms (DRESS) in Taiwan.
  
  
  METHODS
  Case series and retrospective analysis.
  
  
  METHODS
  A medical referral center in Northern Taiwan.
  
  
  METHODS
  Sixty cases of DRESS occurring from June 1998 to May 2008.
  
  
  METHODS
  Clinical characteristics for specific drugs and important prognostic factors in DRESS.
  
  
  RESULTS
  Patients ranged in age from 6 to 90 years (mean age, 51 years). The female to male ratio was 1.3 to 1. The most common culprit drugs were allopurinol, phenytoin, and dapsone. Exanthematous eruption was the most common skin manifestation, but purpurae and blisters were also observed. Hepatic (80%), renal (40%), and pulmonary (33%) involvement were also common. The overall mortality rate was 10%. Allopurinol-induced DRESS was characterized by preceding chronic renal insufficiency and frequent renal involvement. Pancytopenia indicated a poor prognosis.
  
  
  CONCLUSIONS
  Drug reaction with eosinophilia and systemic symptoms has a variable clinical presentation, and its definition requires clarification. It may be a heterogeneous syndrome with some particular patterns related to different drugs. Early diagnosis and prompt discontinuation of offending drug regimens are essential.
authors: Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors: Yi-Chun
authors: YC
authors: Chen
authors: Hsien-Ching
authors: HC
authors: Chiu
authors: Chia-Yu
authors: CY
authors: Chu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000009:adverse effects*; D000890:Anti-Infective Agents / Q000009:adverse effects; D000927:Anticonvulsants / Q000009:adverse effects; D002648:Child; D003622:Dapsone / Q000009:adverse effects*; D003875:Drug Eruptions / Q000150:complications* / Q000453:epidemiology; D004802:Eosinophilia / Q000139:chemically induced* / Q000150:complications / Q000453:epidemiology; D005260:Female; D006074:Gout Suppressants / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010198:Pancytopenia / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology; D010672:Phenytoin / Q000009:adverse effects*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D000927:Anticonvulsants; D006074:Gout Suppressants; D010672:Phenytoin; D000493:Allopurinol; D003622:Dapsone