title: Clinical features of drug-induced hypersensitivity syndrome in 38 patients.
abstract: BACKGROUND
  The clinical features of drug-induced hypersensitivity syndrome (DIHS) or drug rash with eosinophilia and systemic symptoms (DRESS) syndrome are complicated, and the incidence of this condition is very low.
  
  
  OBJECTIVE
  To evaluate the clinical course of DIHS/DRESS and identify effective treatment options.
  
  
  METHODS
  This study was a retrospective analysis of prospectively collected clinical data in 38 consecutive patients with DIHS/DRESS diagnosed between March 2004 and January 2009. We investigated the clinical features, response to treatment, and outcome of 38 patients.
  
  
  RESULTS
  The study patients consisted of 18 men (47.4%) and 20 women (52.6%). The most common causative drugs were anticonvulsants (47.4%) and antibiotics (18.4%), followed by nonsteroidal anti-inflammatory drugs (NSAIDs) (13.2%), allopurinol (5.3%), and undetermined agents (15.8%). The latency period ranged from 3 to 105 days, with a mean (SD) of 25.2 (21.5) days. Systemic corticosteroids were administered to 16 patients (42.1%). Twenty-two (57.9%) patients were treated with topical corticosteroids and antihistamines (no systemic corticosteroids). Complete recovery was noted in 36 patients (94.8%). Two of the patients treated with systemic corticosteroids had a poor outcome: one died due to an opportunistic infection secondary to long-term systemic corticosteroid treatment; the other showed progressive deterioration of liver damage, although the final outcome is not known.
  
  
  CONCLUSIONS
  The drugs associated with DIHS/DRESS were variable and most frequently included anticonvulsants, beta-lactam antibiotics, and NSAIDs. The syndrome was more common than generally recognized. Additional studies are needed to evaluate the clinical indications for systemic corticosteroids in patients with DIHS/DRESS.
authors.affiliation: Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea.
authors.forename: S J
authors.initials: SJ
authors.lastname: Um
authors.forename: S K
authors.initials: SK
authors.lastname: Lee
authors.forename: Y H
authors.initials: YH
authors.lastname: Kim
authors.forename: K H
authors.initials: KH
authors.lastname: Kim
authors.forename: C H
authors.initials: CH
authors.lastname: Son
authors.forename: M S
authors.initials: MS
authors.lastname: Roh
authors.forename: M K
authors.initials: MK
authors.lastname: Lee
mesh_terms: D000284:Administration, Oral; D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000927:Anticonvulsants / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D005260:Female; D006633:Histamine Antagonists; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000927:Anticonvulsants; D006633:Histamine Antagonists