Naslov
Drug rash with eosinophilia and systemic symptoms (DRESS)

Autori
Martinović, Marija ; Peternel, Sandra

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
4th Congress of Emergency Medicine with International Participation / - Rijeka, 2019

Skup
4th Congress of Emergency Medicine with International Participation

Mjesto i datum
Rijeka, Hrvatska, 29.03.2019. - 31.03.2019

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Domaća recenzija

Ključne riječi
Drug Eruption ; Drug Reaction with Eosinophilia and Systemic Symptoms ; Drug Hypersensitivity Syndrome ; DRESS syndrome ; Hepatitis

Sažetak
Introduction: Drug Rash with Eosinophilia and Systemic Symptoms (DRESS), also known as Drug-Induced Hypersensitivity Syndrome (DIHS), is a severe adverse drug reaction accompanied by multi- organ involvement. Although the mortality from DRESS/DIHS is estimated to be around 10%, patients with this syndrome are frequently misdiagnosed and undertreated, probably due to lack of awareness. Aim: to report a single-center observational case series of patients diagnosed with DRESS over a 5-year period. Methods: We searched medical records of patients treated for generalized rash at the Department of Dermatovenereology of the Clinical Hospital Center Rijeka in the period from 2014- 2018. Cases of DRESS were identified according to the European Registry of Severe Cutaneous Adverse Reactions (RegiSCAR) criteria. A retrospective review of demographic data, culprit drugs, latency periods, clinical and laboratory findings was performed. Results: The study population included 8 female patients with a median age of 53.5 years (range 30-91). All patients presented with morbilliform rash, fever (38.3- 40ºC), hepatitis and elevated C-reactive protein (23.9-97.9 mg/L). Seven patients (88%) had facial edema. Eosinophilia was noted in three (38%), the affection of kidney in four (50%) and thyroiditis in one (13%) patient. The latency period ranged from 1 to 6 weeks and causative drugs were phenobarbital, oxcarbazepine, lamotrigine, sulfasalazine, cefalexin, imipenem, metronidazole, clarithromycin and vemurafenib. All patients were treated with a prolonged course of systemic corticosteroids resulting in normalization of the laboratory abnormalities and gradual resolution of the rash over a period of 3 to 7 weeks. Conclusion: DRESS seems to occur more frequently in women with antibiotics and anticonvulsants being the most frequent culprit drugs. The commonest manifestations of DRESS in our series were rash, facial edema, fever, elevated C-reactive protein and hepatitis, whereas eosinophilia was not identified as a consistent finding. Systemic corticosteroids are an effective management option associated with good clinical outcomes.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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