title: Long-term sequelae of drug reaction with eosinophilia and systemic symptoms: a retrospective cohort study from Taiwan.
abstract: BACKGROUND
  The development of autoimmune sequelae is one of the characteristic features of drug reaction with eosinophilia and systemic symptoms (DRESS) or drug-induced hypersensitivity syndrome; however, the incidence of sequelae and prognosis of patients with DRESS are unknown.
  
  
  OBJECTIVE
  We sought to investigate the incidence of sequelae, including less well-known sequelae, and long-term prognosis in patients with DRESS/drug-induced hypersensitivity syndrome.
  
  
  METHODS
  A retrospective cohort study was conducted at a medical center in northern Taiwan using a DRESS/drug-induced hypersensitivity syndrome database. Patients who were followed up for at least 1 year were included in the study.
  
  
  RESULTS
  Nine patients died before interview, whereas 43 patients completed a specially designed questionnaire. The overall cumulative incidence of long-term sequelae was 11.5% (6 of 52 patients). Four patients developed autoimmune diseases, specifically Graves disease (n = 2), type 1 diabetes mellitus (n = 1), and autoimmune hemolytic anemia (n = 1). Alopecia areata was also noted in 1 of the 2 patients with Graves disease. The other 2 patients developed renal failure after visceral involvement and required lifetime hemodialysis.
  
  
  CONCLUSIONS
  Our study included a small number of patients. Further, viral studies were not performed.
  
  
  CONCLUSIONS
  The sequelae of DRESS can be divided into 2 major types that appear to occur in different age groups: young patients tend to develop autoimmune diseases, whereas elderly patients are more vulnerable to end-organ failure.
authors.affiliation: Department of Dermatology, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Chen
authors.forename: Chia-Ying
authors.initials: CY
authors.lastname: Chang
authors.forename: Yung-Tsu
authors.initials: YT
authors.lastname: Cho
authors.forename: Hsien-Ching
authors.initials: HC
authors.lastname: Chiu
authors.forename: Chia-Yu
authors.initials: CY
authors.lastname: Chu
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000209:etiology; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000209:etiology; D004342:Drug Hypersensitivity / Q000150:complications*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000150:complications*; D004802:Eosinophilia / Q000139:chemically induced* / Q000150:complications; D005260:Female; D006111:Graves Disease / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013624:Taiwan