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"Drug reaction with eosinophilia and systemic symptoms"

Chonlaphat Sukasem, Chonlawat Chaichan, Thapanat Nakkrut, Patompong Satapornpong, Kanoot Jaruthamsophon, Thawinee Jantararoungtong, Napatrupron Koomdee, Suthida Sririttha, Sadeep Medhasi, Sarawut Oo-Puthinan, Ticha Rerkpattanapipat, Jettanong Klaewsongkram, Pawinee Rerknimitr, Papapit Tuchinda, Leena Chularojanamontri, Napatra Tovanabutra, Apichaya Puangpetch, Wichai Aekplakorn
The HLA-B ∗ 15:02 allele has been reported to have a strong association with carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) in Thai patients. The HLA-B alleles associated with carbamazepine-induced maculopapular exanthema (MPE) and the drug reaction with eosinophilia and systemic symptoms (DRESS) among the Thai population have never been reported. The aim of the present study was to carry out an analysis of the involvement of HLA-B alleles in carbamazepine-induced cutaneous adverse drug reactions (cADRs) in the Thai population...
2018: Journal of Immunology Research
Kazuya Miyashita, Fumi Miyagawa, Yuki Nakamura, Rie Ommori, Hiroaki Azukizawa, Hideo Asada
No abstract text is available yet for this article.
March 15, 2018: Acta Dermato-venereologica
Abhishek De, Murlidhar Rajagopalan, Aarti Sarda, Sudip Das, Projna Biswas
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, is also known as drug induced hypersensitivity syndrome and by various other names. It is now recognised as one of the severe cutaneous adverse reaction (SCAR) and can be potentially life-threatening. Historically, it was most frequently linked with phenytoin and was initially described as phenytoin hypersensitivity syndrome. However, it was later found to be caused by various other medications. Anticonvulsants and sulfonamides are the most common offender...
January 2018: Indian Journal of Dermatology
Fanping Yang, Sheng-An Chen, Xiaojin Wu, Qingyuan Zhu, Xiaoqun Luo
Drug reaction with eosinophilia and systemic symptoms (DRESS) is characterised by skin rash and multivisceral involvement. The liver is the organ most frequently affected and the degree of liver function impairment often correlates with the mortality rate of DRESS. We aimed to examine the expression of cytotoxic proteins, including soluble Fas ligand (sFasL), TNF-α, granulysin, perforin, and granzyme B in the sera and skin lesions of patients with DRESS and evaluate their clinical significance. Our cohort consisted of 21 patients with DRESS and control groups including 39 patients with Stevens-Johnson syndrome/toxic epidermal necrolysis, 21 patients with maculopapular eruption, and 29 normal controls...
February 1, 2018: European Journal of Dermatology: EJD
Sapan Kumar Behera, Saibal Das, Alphienes Stanley Xavier, Sandhiya Selvarajan
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a serious and potentially fatal adverse effect to therapeutic medications. The incidence of this condition varies among different ethnicities because of the difference in the genetic makeup. Though fever, rash and eosinophilia are essential features for the diagnosis of this syndrome, these vary from patient to patient along with the involvement of various organs such as liver, kidney, lungs, pancreas, etc. Some of the atypical features are dysphagia, agranulocytosis, and chylous ascites...
March 15, 2018: Hospital Practice (Minneapolis)
Min-Suk Yang, Ju-Young Kim, Min-Gyu Kang, Suh-Young Lee, Jae-Woo Jung, Sang-Heon Cho, Kyung-Up Min, Hye-Ryun Kang
Background/Aims: There are only a few reports on the direct costs of severe cutaneous adverse reactions (SCARs), including drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN), despite the tremendous negative impact these reactions can have on patients. We estimated the direct costs of treating SCARs. Methods: Patients admitted to a tertiary teaching hospital for the treatment of SCARs from January 1, 2005 to December 31, 2010 were included...
February 23, 2018: Korean Journal of Internal Medicine
Wei-Ti Chen, Chuang-Wei Wang, Chun-Wei Lu, Chun-Bing Chen, Hua-En Lee, Shuen-Iu Hung, Siew-Eng Choon, Chih-Hsun Yang, Ming-Tsan Liu, Ting Jui Chen, Wen-Lang Fan, Shih-Chi Su, Yang Yu-Wei Lin, Ya-Ching Chang, Wen-Hung Chung
Dapsone-induced hypersensitivity reactions may cause severe cutaneous adverse reactions (SCAR), such as drug reaction with eosinophilia and systemic symptoms (DRESS). It has been reported that HLA-B*13:01 is strongly associated with dapsone-induced hypersensitivity reactions among leprosy patients. However, the phenotype specificity and detailed immune mechanism of HLA-B*13:01 remains unclear. We investigated the genetic predisposition, HLA-B*13:01 function, and cytotoxic T cells (CTLs) involved in pathogenesis of dapsone-SCAR...
February 16, 2018: Journal of Investigative Dermatology
Jared James, Yasser M Sammour, Andrew R Virata, Terri A Nordin, Igor Dumic
BACKGROUND DRESS is a rare, life threatening syndrome that occurs following exposure to certain medications, most commonly antibiotics and antiepileptics. While sulfonamide antibiotics are frequently implicated as causative agents for DRESS syndrome, furosemide, a nonantibiotic sulfonamide, has not been routinely reported as the causative agent despite its widespread use. CASE REPORT A 63 year old male who started furosemide for lower extremity edema 10 weeks prior presented with diarrhea, fever of 39.4°C, dry cough and maculopapular rash involving >50% of his body...
February 14, 2018: American Journal of Case Reports
Dorota Mehrholz, Anna Emilia Urban, Marta Herstowska, Roman Nowicki, Wiesław Cubała, Wioletta Barańska-Rybak
OBJECTIVES: DRESS (drug reaction with eosinophilia and systemic syndrome) is qualified as hypersensitivity after drug reaction. This syndrome may occur due to any medication intake. There are three main groups of symptoms defining DRESS: skin lesions, hematological abnormalities and internal organ involvement. METHODS: A retrospective study was performed on a group of 261 patients with drug reactions hospitalized in the Clinic of Dermatology from 2004 until 2017...
December 30, 2017: Psychiatria Polska
U D Kombila, W Ka, F B R Mbaye, N F Diouf, L Fall, P Ouedraogo, A N E Koutonin, Y Dia Kane, N Oumar Toure Badiane
INTRODUCTION: The Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) is a severe drug-induced reaction. CASE REPORT: We report the case of a 35-year-old man treated by RHEZ for a first episode of a smear positive pulmonary tuberculosis and who developed a DRESS syndrome due to pyrazinamide after twenty days of treatment, associated with a viral reactivation to Human Herpes Virus 6 (HHV6). He had a skin eruption, liver involvement and hypereosinophilia...
January 2018: Revue des Maladies Respiratoires
Elizabeth J Phillips, Chonlaphat Sukasem, Michelle Whirl-Carrillo, Daniel J Müller, Henry M Dunnenberger, Wasun Chantratita, Barry Goldspiel, Yuan-Tsong Chen, Bruce C Carleton, Alfred L George, Taisei Mushiroda, Teri Klein, Roseann S Gammal, Munir Pirmohamed
The variant allele HLA-B*15:02 is strongly associated with greater risk of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in patients treated with carbamazepine or oxcarbazepine. The variant allele HLA-A*31:01 is associated with greater risk of maculopapular exanthema, drug reaction with eosinophilia and systemic symptoms, and SJS/TEN in patients treated with carbamazepine. We summarize evidence from the published literature supporting these associations and provide recommendations for carbamazepine and oxcarbazepine use based on HLA genotypes...
February 2, 2018: Clinical Pharmacology and Therapeutics
Robert H Witcher, Michelle M Ramirez
PURPOSE: Drug reaction with eosinophilia and systemic symptoms (DRESS) is associated with antiepileptic drug use and is a rare but life-threatening side effect. We present a case of phenobarbital-induced DRESS in a patient who subsequently required phenobarbital and was successfully desensitized. SUMMARY: A 5-year-old male presented with medically refractory status epilepticus (SE). He had been trialed on several antiepileptic medications without achieving burst suppression...
January 1, 2018: Journal of Pharmacy Practice
Linda Chan, Charles Chan, David K Cook
No abstract text is available yet for this article.
March 2018: JAAD Case Reports
Jianhua Liang, Hui Qu, Xiaowen Wang, Aiping Wang, Lingling Liu, Ping Tu, Ruoyu Li, Mingyue Wang
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a hypersensitivity reaction characterized by maculopapular rash, exfoliative dermatitis, lymphadenopathy, fever, eosinophilia, and involvement of internal organs. Evidence for reactivation of herpes family viruses has been observed in some DRESS patients, and activated CD8+ T lymphocytes are largely directed against Epstein-Barr virus. Here, we report two cases complicated with this infection. Both patients received antibiotics and non-steroidal anti-inflammatory drugs...
February 2018: Annals of Dermatology
G T Chua, J S Rosa Duque, P C Y Chong, P P W Lee, Y L Lau, M H K Ho
DRESS (drug reaction with eosinophilia and systemic symptoms) is a rare but potentially life-threatening disorder characterized by fever, skin eruption, haematological abnormalities and multi-organ dysfunction after drug exposure. The pathophysiology is thought to be related to interactions between culprit drugs, viral reactivation and T-lymphocytes activation. We report 4 paediatric patients with DRESS who were treated at our centre over the past 12 years. Most cases improved after corticosteroids. Other immunosuppressive medications were attempted in refractory cases with varied outcomes...
November 30, 2017: European Annals of Allergy and Clinical Immunology
Irvin Suástegui-Rodríguez, Karin Ivette Campos-Jiménez, Judith Domínguez-Cherit, Silvia Méndez-Flores Malvido-Torres
Adverse cutaneous reactions to drugs are any undesirable change in the structure or function of the skin. These are among the adverse side effects to common drugs. The most commonly implicated drugs are antibiotics and anticonvulsants. Cutaneous clinical manifestations are diverse ranging from mild or moderate reactions, such as urticaria and maculopapular rash, to severe cutaneous adverse reactions (SCAR), which are known due to their high morbidity and mortality (among these: Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS)...
January 2018: Revista Médica del Instituto Mexicano del Seguro Social
Ibrahim Tawhari, Fawaz Tawhari, Mossab Aljuaid
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe, potentially life-threatening idiosyncratic drug reaction that may result in skin eruption, mucous membrane involvement, eosinophilia, atypical lymphocytosis and lymphadenopathy, with wide-ranging internal organ involvement. The authors report the case of a 21-year-old man who was prescribed lamotrigine for anxiety disorder. After 2 weeks of treatment, he developed a pruritic morbilliform rash on his trunk and upper extremities that was associated with fever, sore throat, bilateral scleral injection, nausea, vomiting and abdominal pain...
January 23, 2018: BMJ Case Reports
E Özkaya, S Kılıç
Antiepileptic drugs (AEDs) are the mainstay of treatment for 1% of the human population suffering from epilepsy.1 They are also increasingly used for several non-epileptic neurological conditions, such as trigeminal neuralgia, neuropathic pain syndromes, migraine and psychiatric disorders.2 Three percent of patients who receive AEDs experience adverse cutaneous drug reactions (ACDR),3 which can range across a wide spectrum from mild to moderate eruptions, such as maculopapular rash and, urticaria, to severe and life-threatening conditions, such as drug reactions with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN)...
January 22, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Maggie L Chow, David Kim, Sonia Kamath, David Peng, Minnelly Luu
A 3-month-old girl with Sturge-Weber syndrome presented with a morbilliform rash, eosinophilia, and fulminant liver failure to our tertiary pediatric hospital. She was diagnosed with drug reaction with eosinophilia and systemic symptoms complicated by viremia and evidence of viral hepatitis on liver biopsy. We discuss the role of viral reactivation in drug reaction with eosinophilia and systemic symptoms and the relevance of antiviral therapy in management.
January 15, 2018: Pediatric Dermatology
Wendy C Fang, Nikki R Adler, Linda V Graudins, Caitlin Goldblatt, Michelle Sy Goh, Stuart K Roberts, Jason A Trubiano, Ar Kar Aung
BACKGROUND: Drug-induced liver injury can be associated with certain cutaneous adverse drug reactions. AIMS: We aim to demonstrate the prevalence of drug-induced liver injury in patients with cutaneous adverse drug reactions. Severity and patterns of liver injury, risk factors, causal medications and outcomes are also examined. METHODS: A retrospective cohort study of patients with cutaneous adverse drug reactions was conducted across two hospitals in Australia...
January 8, 2018: Internal Medicine Journal
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