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Drug rash with eosinophilia and systemic symptoms

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https://www.readbyqxmd.com/read/28412864/cutaneous-allergic-drug-reactions-update-on-pathophysiology-diagnostic-procedures-and-differential-diagnostic
#1
Galina Balakirski, Hans F Merk
Important changes in the understanding and management of drug hypersensitivity reactions during the last years result from the increasing importance of biologics in medical practice, which differ in their spectrum of adverse drug reactions (ADRs) from the classical covalent drugs. With regard to covalent drugs, ampicillin and amoxicillin as well as clavulanic acid play an increasing role among ADRs to betalactam antibiotics. Fluoroquinolones are mainly the cause of anaphylactic and photosensitivity reactions...
April 17, 2017: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/28397724/drug-reaction-with-eosinophilia-and-systemic-symptoms-retrospective-analysis-of-104-cases-over-one-decade
#2
Li Wang, Xue-Ling Mei
BACKGROUND: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe, life-threatening disorder caused by drugs. In the present study, we tried to explore the types of DRESS-inducing drugs, incubation period, features of skin rashes, accompanying visceral damage, and effectiveness of glucocorticoid therapy so as to inform clinical practice. METHODS: Patients diagnosed with a drug-induced rash, dermatitis, and DRESS admitted to our hospital from January 2006 to December 2015 were included in the study...
April 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28392649/drug-reaction-with-eosinophilia-and-systemic-symptom-syndrome-induced-by-lamotrigine
#3
Song Hee Han, Min Seok Hur, Hae Jeong Youn, Nam Kyung Roh, Yang Won Lee, Yong Beom Choe, Kyu Joong Ahn
Drug reaction with eosinophilia and systemic symptom (DRESS) syndrome is a type of severe adverse drug-induced reaction. Dermatologists should make a quick diagnosis and provide appropriate treatment for DRESS syndrome to reduce mortality rates, which can be as high as 10%. We present the case of a 47-year-old man with schizoaffective disorder treated with lamotrigine who developed DRESS syndrome to emphasize the importance of close observation of patients with drug eruption. He was consulted for erythematous maculopapular rashes on the trunk that developed 3 weeks after starting lamotrigine...
April 2017: Annals of Dermatology
https://www.readbyqxmd.com/read/28391407/influence-of-genetic-and-non-genetic-factors-on-phenytoin-induced-severe-cutaneous-adverse-drug-reactions
#4
Kittika Yampayon, Chonlaphat Sukasem, Chanin Limwongse, Yotin Chinvarun, Therdpong Tempark, Ticha Rerkpattanapipat, Pornpimol Kijsanayotin
PURPOSE: The purpose of this study was to investigate the association of genetic factors including variants in HLA-B and CYP2C genes and non-genetic factors with phenotype-specific phenytoin (PHT)-induced severe cutaneous adverse reactions (SCARs) in Thai patients. METHODS: Thirty-six PHT-induced SCAR cases (15 Stevens-Johnson syndrome (SJS) and 21 drug rash with eosinophilia and systemic symptoms (DRESS)/drug hypersensitivity syndrome (DHS)) and 100 PHT-tolerant controls were studied...
April 8, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28315874/multiple-drug-hypersensitivity
#5
Werner J Pichler, Yuttana Srinoulprasert, James Yun, Oliver Hausmann
Multiple drug hypersensitivity (MDH) is a syndrome that develops as a consequence of massive T-cell stimulations and is characterized by long-lasting drug hypersensitivity reactions (DHR) to different drugs. The initial symptoms are mostly severe exanthems or drug rash with eosinophilia and systemic symptoms (DRESS). Subsequent symptoms due to another drug often appear in the following weeks, overlapping with the first DHR, or months to years later after resolution of the initial presentation. The second DHR includes exanthema, erythroderma, DRESS, Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), hepatitis, and agranulocytosis...
March 18, 2017: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/28296768/difficult-clinical-management-of-antituberculosis-dress-syndrome-complicated-by-mrsa-infection-a-case-report
#6
Li Wang, Lin-Feng Li
RATIONALE: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe drug-induced hypersensitivity reaction characterized by skin rash, fever, blood abnormalities, and multiple organ involvement. The diagnosis of DRESS syndrome is often delayed because of its variable presentation. Prompt withdrawal of the culprit drug is the definitive treatment. DRESS syndrome induced by antituberculosis drugs has rarely been reported. PATIENT CONCERNS: A 50-year-old man admitted to our hospital with recurrent episodes of progressive rash, fever, eosinophilia, lymphadenopathy, hepatic, and pulmonary involvement were experienced after repeat trials of the same antituberculosis drugs...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28288233/-dress-syndrome-in-paediatrics-clinical-case
#7
Marcos Silva-Feistner, Elena Ortiz, María Jesús Rojas-Lechuga, Daniel Muñoz
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, potentially life-threatening, drug-induced hypersensitivity reaction that includes skin eruption, haematological abnormalities, lymphadenopathy, and internal organ involvement. OBJECTIVE: Presenting a rare condition in children, to facilitate a rapid diagnostic suspicion and recognition by doctors. CASE REPORT: An 9 months old infant admitted due to a severe viral pneumonia, managed with non-invasive ventilation and ceftriaxone...
February 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28275024/levetiracetam-induced-eosinophilic-pneumonia
#8
Aisling Fagan, Jonathan Fuld, Elaine Soon
Levetiracetam is widely regarded as a benign antiepileptic drug, compared to older antiepileptic medication. We report a case of eosinophilic pneumonia due to levetiracetam use in a non-smoking woman aged 59 years with no previous respiratory history. Our patient presented with exertional breathlessness and marked desaturation on exertion. She displayed 'reverse bat-wing' infiltrates on her chest radiograph and peripheral eosinophilia on a complete blood count. Her symptoms, radiology and peripheral eosinophilia resolved completely with cessation of levetiracetam and a course of prednisolone...
March 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28225953/drug-reaction-with-eosinophilia-and-systemic-symptoms-dress-and-its-relation-with-autoimmunity-in-a-reference-center-in-mexico
#9
Juan Manuel Ruiz Matta, Silvia Méndez Flores, Judith Domínguez Cherit
BACKGROUND: Drug reaction with eosinophilia and systemic symptoms is a severe adverse drug reaction, with a reported mortality of 10%. Long-term outcomes involve organic failure and autoimmune diseases in some populations. OBJECTIVE: To evaluate the clinical prognosis of patients with drug reaction with eosinophilia and systemic symptoms. METHODS: We conducted a retrospective review at a referral hospital in Mexico City in a period of 22 years (1992-2013), looking up for records with diagnosis of DRESS according to RegiSCAR criteria...
January 2017: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/28203363/an-exploratory-factor-analysis-of-the-spontaneous-reporting-of-severe-cutaneous-adverse-reactions
#10
Manfred Hauben, Eric Hung, Wen-Yaw Hsieh
BACKGROUND: Severe cutaneous adverse reactions (SCARs) are prominent in pharmacovigilance (PhV). They have some commonalities such as nonimmediate nature and T-cell mediation and rare overlap syndromes have been documented, most commonly involving acute generalized exanthematous pustulosis (AGEP) and drug rash with eosinophilia and systemic symptoms (DRESS), and DRESS and toxic epidermal necrolysis (TEN). However, they display diverse clinical phenotypes and variations in specific T-cell immune response profiles, plus some specific genotype-phenotype associations...
January 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/28144463/drug-reaction-with-eosinophilia-and-systemic-symptoms-induced-by-valproic-acid-a-case-report
#11
Mahboubeh Darban, Bahador Bagheri
INTRODUCTION: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but life-threatening reaction to drugs such as carbamazepine and allopurinol. The condition is characterized by skin rashes, fever, hematological disturbances, lymphadenopathy, and organ failure, most probably hepatic dysfunction. To date, only a few cases of valproate-induced DRESS syndrome have been reported. CASE PRESENTATION: We report on the case of a 60-year-old man who had been treated with valproic acid some time before being referred to Kowsar Hospital, Semnan, Iran in December 2015...
September 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/28138822/drug-reaction-with-eosinophilia-and-systemic-symptoms-dress-syndrome-and-the-rheumatologist
#12
REVIEW
Marwan H Adwan
PURPOSE OF THE REVIEW: The purpose of the review is to summarise the various drugs used in rheumatology practice implicated in the causation of DRESS syndrome. RECENT FINDINGS: The most commonly reported drugs are allopurinol, sulfasalazine and minocycline, which pose a very high risk for DRESS syndrome development, followed by strontium ranelate and dapsone. Other, less commonly reported, drugs include leflunomide, hydroxychloroquine, non-steroidal anti-inflammatory drugs, febuxostat, bosentan and solcitinib...
January 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28008656/human-herpesvirus-6-hhv-6b-lymphadenitis-in-dress-syndrome-a-lymphoma-mimic
#13
Steven Johnson, Stephanie Mathews, David S Hudnall
AIMS: Lymphadenopathy, hematologic abnormalities, and constitutional symptoms are among the non-specific manifestations seen in drug rash with eosinophilia and systemic symptoms (DRESS), an uncommon but potentially fatal cutaneous adverse drug reaction. The ubiquitous human herpesvirus 6 (HHV-6) plays a unique role in the pathogenesis of DRESS, with emerging data suggesting that reactivation occurs in most cases and contributes to the clinical manifestations, including lymphadenopathy...
December 23, 2016: Histopathology
https://www.readbyqxmd.com/read/28000142/drug-reaction-with-eosinophilia-and-systemic-symptoms-dress-with-teicoplanin-a-case-report
#14
Sholeh Ebrahimpour, Mehdi Mohammadi, Kheirollah Gholami
Intramuscular teicoplanin (400 mg every 12 h for three doses, then 400 mg daily, intramuscularly) was prescribed for a 37-year-old woman with presumptive diagnosis of cellulitis. On the 14th day of treatment, she developed generalized maculopapular rash, accompanied by fever, wheezing, shortening of breath, and lymphadenopathy. Lab tests revealed abnormal liver enzymes, leukocytosis, and eosinophilia. The treatment was interrupted with suspicion of drug reaction. Fever subsided after 48 h. Skin eruption and respiratory symptoms began to resolve within 2 weeks...
December 2017: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27996289/cardiac-involvement-in-dress-syndrome
#15
Tomon Thongsri, Leena Chularojanamontri, Werner J Pichler
OBJECTIVE: Cardiac involvement in drug rash with eosinophilia and systemic symptoms (DRESS) syndrome varies considerably between 4% and 21%. Here we present our case and review literatures for its diagnosis and management. An algorithm for diagnosis of cardiac involvement in DRESS syndrome is proposed in this article. DATA SOURCES: Data regarding DRESS-associated myocarditis and eosinophilic myocarditis were gather primarily from MEDLINE database. RESULTS: DRESS syndrome is a hypersensitivity reaction which is due to massive T cell stimulation resulting in cytotoxicity and eosinophil activation and recruitment...
December 12, 2016: Asian Pacific Journal of Allergy and Immunology
https://www.readbyqxmd.com/read/27979020/antiepilepsy-drugs-and-the-immune-system
#16
REVIEW
Neetu Godhwani, Sami L Bahna
OBJECTIVE: To alert physicians about the peculiar adverse effects of antiepilepsy drugs (AEDs) on the immune system. DATA SOURCES: PubMed literature during the past 25 years. STUDY SELECTIONS: Reports and review articles on the hypersensitivities of AEDs and their effect on immunity. RESULTS: AEDs have significant effects on the immune system in the form of hypersensitivity or immune suppression. IgE-mediated reactions can be urticaria, angioedema, bronchospasm, or anaphylaxis...
December 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27922762/nonchemotherapy-drug-induced-agranulocytosis-in-children-detected-by-a-prospective-pharmacovigilance-program
#17
Nicolás Medrano-Casique, Hoi Y Tong, Alberto M Borobia, Antonio J Carcas, Jesús Frías, Elena Ramírez
OBJECTIVES: A prospective evaluation of nonchemotherapy drug-induced agranulocytosis (DIA) cases, which are infrequent in the pediatric population. We characterize agranulocytosis cases and assess lab test differences between drug- and nondrug-induced agranulocytosis. METHODS: Through our Prospective Pharmacovigilance Program from Laboratory Signals at Hospital we detected pediatric agranulocytosis cases from July 2007 to December 2010. This program estimates the incidence, drug causality, clinical features, outcomes of DIA pediatric cases, and assesses laboratory differences with respect to non-DIA...
October 2016: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/27843869/skin-rash-eosinophilia-and-renal-impairment-in-a-patient-recently-started-on-allopurinol
#18
Ashraf Jmeian, Amer Hawatmeh, Razan Shamoon, Fayez Shamoon, Michael Guma
Allopurinol is a hypoxanthine analog which inhibits xanthine oxidase, it is a widely used medication for the treatment of hyperuricemia and gout. Allopurinol-induced drug-induced rash with eosinophilia and systemic symptoms syndrome is an infrequent, life-threatening adverse reaction of allopurinol therapy that is remarkable for the higher mortality rate with the use of allopurinol than with the use of another agent. We present a case of a 62-year-old male with a history of chronic kidney disease stage 3, hypertension and gout who developed skin rash, eosinophilia, and renal impairment 2 weeks after he was started on allopurinol therapy for gout...
April 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/27788881/slow-desensitization-of-imatinib-induced-nonimmediate-reactions-and-dynamic-changes-of-drug-specific-cd4-cd25-cd134-lymphocytes
#19
Jettanong Klaewsongkram, Pattarawat Thantiworasit, Pimpayao Sodsai, Supranee Buranapraditkun, Pungjai Mongkolpathumrat
BACKGROUND: Imatinib is a tyrosine kinase inhibitor indicated for the treatment of gastrointestinal stromal tumors (GISTs) and certain neoplastic diseases; however, nonimmediate adverse reactions are common. OBJECTIVE: To describe the process of imatinib slow desensitization in patients who experienced nonimmediate reactions to imatinib and the dynamic change in drug-specific CD4(+)CD25(+)CD134(+) T-lymphocyte percentages. METHODS: Five patients diagnosed as having GISTs and with a recent history of imatinib-induced nonimmediate reactions (maculopapular exanthema with eosinophilia, exfoliative dermatitis, palmar-plantar erythrodysesthesia, and drug rash with eosinophilia and systemic symptoms) were desensitized using a slow desensitization protocol...
November 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27740720/dress-syndrome-in-a-patient-with-cystic-fibrosis-a-case-report
#20
Sophie Gohy, Antoine Froidure, Patrick Lebecque
Drug reaction with eosinophilia and systemic symptom (DRESS) syndrome is a rare and severe side-effect, mainly described after intake of anticonvulsants, allopurinol, or antibiotics. It usually begins within 2 months after drug introduction. Symptoms include cutaneous rash, hematologic abnormalities, and internal organ involvement and the diagnosis might be challenging. This case report illustrates for the first time this life-threatening complication in a patient with cystic fibrosis (CF). In this case, withdrawal of the offending drug was sufficient for full recovery...
October 14, 2016: Pediatric Pulmonology
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