title: Six-year retrospective review of drug reaction with eosinophilia and systemic symptoms.
abstract: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, severe adverse drug reaction. The aim of this study was to characterize the aetiology, clinical features, laboratory findings, and management of patients with DRESS, diagnosed from January 2005 to April 2010 in a tertiary centre in Thailand. Twenty-seven patients were included in the study with a mean age of 52 years. Phenytoin, allopurinol, and nevirapine were the most commonly implicated medications. Mean duration of drug administration before the onset of symptoms was 34 days. The latent period was longer for allopurinol (103 days) and shorter for nevirapine (10 days). Skin rash was seen in all patients, while fever and lymphadenopathy were found in 88.9% and 22.2%, respectively. Hepatic and haematological involvement were the two most common systemic complications, occurring in 96.3% and 85.2%, respectively. Most patients were treated with systemic corticosteroids, for a mean duration of 49 days. The mortality rate in this study was 3.7%. Early detection and discontinuation of the suspected drug are the key steps of management.
authors: Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors: Pranee
authors: P
authors: Wongkitisophon
authors: Kumutnart
authors: K
authors: Chanprapaph
authors: Ploysyne
authors: P
authors: Rattanakaemakorn
authors: Vasanop
authors: V
authors: Vachiramon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000009:adverse effects; D019380:Anti-HIV Agents / Q000009:adverse effects; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000927:Anticonvulsants / Q000009:adverse effects; D003907:Dexamethasone / Q000627:therapeutic use; D003875:Drug Eruptions / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D004487:Edema / Q000139:chemically induced / Q000150:complications / Q000628:therapy; D004791:Enzyme Inhibitors / Q000009:adverse effects; D004802:Eosinophilia / Q000139:chemically induced* / Q000150:complications / Q000628:therapy; D005145:Face; D005260:Female; D005334:Fever / Q000139:chemically induced / Q000150:complications / Q000628:therapy; D006801:Humans; D008099:Liver / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D019829:Nevirapine / Q000009:adverse effects; D010672:Phenytoin / Q000009:adverse effects; D011239:Prednisolone / Q000627:therapeutic use; D011537:Pruritus / Q000139:chemically induced / Q000150:complications / Q000628:therapy; D012008:Recurrence; D012189:Retrospective Studies; D013785:Thailand; D013997:Time Factors; D028761:Withholding Treatment; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D000893:Anti-Inflammatory Agents; D000927:Anticonvulsants; D004791:Enzyme Inhibitors; D010672:Phenytoin; D000493:Allopurinol; D003907:Dexamethasone; D019829:Nevirapine; D011239:Prednisolone