title: Drug reaction with eosinophilia and systemic symptoms syndrome is not uncommon and shows better clinical outcome than generally recognised.
abstract: BACKGROUND
  Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare disease which can cause severe morbidity and mortality. The aim of this study is to evaluate the clinical manifestation and course of DRESS syndrome.
  
  
  METHODS
  We conducted a retrospective analysis of prospectively collected data in 45 patients with DRESS syndrome diagnosed between September 2009 and August 2011.
  
  
  RESULTS
  The most common causative drug group was antibiotics (n=13, 28.9%), followed by anticonvulsants (n=12, 26.7%), antituberculosis drugs (n=6, 13.3%), non-steroidal anti-inflammatory drugs (n=4, 8.9%), undetermined agents (n=4, 8.9%), allopurinol (n=3, 6.7%), and others (n=3, 6.7%). The latency period ranged from 2 to 120 days, with a mean of 20.2 ± 24.3 days. The longest latency period was noted for the antituberculosis drug group, at 46.5 ± 29.9 days. Eosinophilia in peripheral blood examination was noted in 35 subjects (77.8%). Atypical lymphocytosis was noted in 16 patients (35.6%), and thrombocytopenia in seven patients (15.6%). Hepatic involvement was noted in 39 (86.7%) study patients, kidney in eight (17.8%), lung in four (8.9%), and central nervous system in one (2.3%). Systemic corticosteroids were administered to 10 patients (22.2%). Forty-three patients (95.6%) showed complete recovery, while two patients had poor outcomes.
  
  
  CONCLUSIONS
  DRESS syndrome was not more uncommon than generally recognised. Antibiotics were the most frequently implicated drug group, followed by anticonvulsants. Most patients with this disease showed a better clinical outcome than that which had been generally expected.
authors.affiliation: Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea.
authors.forename: Y H
authors.initials: YH
authors.lastname: Nam
authors.affiliation: Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea.
authors.forename: M R
authors.initials: MR
authors.lastname: Park
authors.affiliation: Department of Pharmacy, Dong-A University Hospital, Busan, Republic of Korea.
authors.forename: H J
authors.initials: HJ
authors.lastname: Nam
authors.affiliation: Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea. Electronic address: skleeai@dau.ac.kr.
authors.forename: S K
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Dermatology, College of Medicine, Dong-A University, Busan, Republic of Korea.
authors.forename: K H
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Pathology, College of Medicine, Dong-A University, Busan, Republic of Korea.
authors.forename: M S
authors.initials: MS
authors.lastname: Roh
authors.affiliation: Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea.
authors.forename: S-J
authors.initials: SJ
authors.lastname: Um
authors.affiliation: Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea.
authors.forename: C-H
authors.initials: CH
authors.lastname: Son
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000276:immunology; D000900:Anti-Bacterial Agents / Q000276:immunology; D000927:Anticonvulsants / Q000276:immunology; D000995:Antitubercular Agents / Q000276:immunology; D063926:Drug Hypersensitivity Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D004802:Eosinophilia / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000485:Allergens; D000900:Anti-Bacterial Agents; D000927:Anticonvulsants; D000995:Antitubercular Agents
keywords: Anticonvulsants; Drug hypersensitivity; Eosinophilia