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Drug rash with eosinophilia and systemic symptoms

MedGen UID:
762193
•Concept ID:
C3541994
•
Disease or Syndrome
Synonym: Drug hypersensitivity syndrome
SNOMED CT: DRESS syndrome (702809001); Drug reaction with eosinophilia and systemic symptoms (702809001); Drug rash with eosinophilia and systemic symptoms (702809001); Drug-induced hypersensitivity syndrome (702809001); Anticonvulsant hypersensitivity syndrome (702809001)
Modes of inheritance:
Not genetically inherited
MedGen UID:
988794
•Concept ID:
CN307044
•
Finding
Source: Orphanet
clinical entity without genetic inheritance.
See: This record
Not genetically inherited (Orphanet)
 
Monarch Initiative: MONDO:0015340
Orphanet: ORPHA139402

Definition

A drug hypersensitivity reaction with a relatively long latency period after exposure characterised by rash, fever, lymphadenopathy, haematologic abnormalities including eosinophilia and atypical lymphocytosis and internal organ involvement. Clinical presentation is highly variable. Eosinophilia is present in 50-90% of cases. [from SNOMEDCT_US]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVDrug rash with eosinophilia and systemic symptoms

Professional guidelines

PubMed

Management of Cutaneous Immune-Related Adverse Events in Patients With Cancer Treated With Immune Checkpoint Inhibitors: A Systematic Review.
Nadelmann ER, Yeh JE, Chen ST
JAMA Oncol 2022 Jan 1;8(1):130-138. doi: 10.1001/jamaoncol.2021.4318. PMID: 34709352
Cenobamate for the treatment of focal epilepsies.
Strzelczyk A, Mann C, Willems LM, Rosenow F, Bauer S
Expert Opin Pharmacother 2020 Dec;21(18):2215-2223. Epub 2020 Aug 19 doi: 10.1080/14656566.2020.1803830. PMID: 32812825
Hypersensitivity reactions to proton-pump inhibitors: Clinical presentation, diagnosis, and management.
Kepil Özdemir S, Bavbek S
Allergy Asthma Proc 2020 Mar 1;41(2):e37-e44. doi: 10.2500/aap.2020.41.190033. PMID: 32122452

Recent clinical studies

Etiology

Drug reaction with eosinophilia and systemic symptoms: A single center descriptive observational study.
Sandhu S, Neema S, Vashisht D, Venugopal R, Sengupta P, Radhakrishnan S
Dermatol Ther 2021 Jan;34(1):e14670. Epub 2020 Dec 23 doi: 10.1111/dth.14670. PMID: 33314590
Cenobamate for the treatment of focal epilepsies.
Strzelczyk A, Mann C, Willems LM, Rosenow F, Bauer S
Expert Opin Pharmacother 2020 Dec;21(18):2215-2223. Epub 2020 Aug 19 doi: 10.1080/14656566.2020.1803830. PMID: 32812825
Multiple Drug Hypersensitivity.
Pichler WJ, Srinoulprasert Y, Yun J, Hausmann O
Int Arch Allergy Immunol 2017;172(3):129-138. Epub 2017 Mar 18 doi: 10.1159/000458725. PMID: 28315874Free PMC Article
Allopurinol-induced DRESS syndrome.
Markel A
Isr Med Assoc J 2005 Oct;7(10):656-60. PMID: 16259349
Drug rash with eosinophilia and systemic symptoms (DRESS syndrome).
Tas S, Simonart T
Acta Clin Belg 1999 Aug;54(4):197-200. PMID: 10544509

Diagnosis

Immediate and Delayed Hypersensitivity Reactions to Antibiotics: Aminoglycosides, Clindamycin, Linezolid, and Metronidazole.
Dilley M, Geng B
Clin Rev Allergy Immunol 2022 Jun;62(3):463-475. Epub 2021 Dec 15 doi: 10.1007/s12016-021-08878-x. PMID: 34910281Free PMC Article
DRESS syndrome: clinical myths and pearls.
Isaacs M, Cardones AR, Rahnama-Moghadam S
Cutis 2018 Nov;102(5):322-326. PMID: 30566546
A review of DRESS-associated myocarditis.
Bourgeois GP, Cafardi JA, Groysman V, Hughey LC
J Am Acad Dermatol 2012 Jun;66(6):e229-36. Epub 2011 Jun 11 doi: 10.1016/j.jaad.2010.11.057. PMID: 21658796
Sulphasalazine-induced DRESS.
Teo L, Tan E
Singapore Med J 2006 Mar;47(3):237-9. PMID: 16518561
Allopurinol-induced DRESS syndrome.
Markel A
Isr Med Assoc J 2005 Oct;7(10):656-60. PMID: 16259349

Therapy

Immediate and Delayed Hypersensitivity Reactions to Antibiotics: Aminoglycosides, Clindamycin, Linezolid, and Metronidazole.
Dilley M, Geng B
Clin Rev Allergy Immunol 2022 Jun;62(3):463-475. Epub 2021 Dec 15 doi: 10.1007/s12016-021-08878-x. PMID: 34910281Free PMC Article
Management of Cutaneous Immune-Related Adverse Events in Patients With Cancer Treated With Immune Checkpoint Inhibitors: A Systematic Review.
Nadelmann ER, Yeh JE, Chen ST
JAMA Oncol 2022 Jan 1;8(1):130-138. doi: 10.1001/jamaoncol.2021.4318. PMID: 34709352
Telaprevir-induced DRESS.
Kesar V, Kesar V, Khaitova V, Motamed D, Schiano T
J Drugs Dermatol 2014 Feb;13(2):199-200. PMID: 24509972
Sulphasalazine-induced DRESS.
Teo L, Tan E
Singapore Med J 2006 Mar;47(3):237-9. PMID: 16518561
Allopurinol-induced DRESS syndrome.
Markel A
Isr Med Assoc J 2005 Oct;7(10):656-60. PMID: 16259349

Prognosis

Trimethoprim-Sulfamethoxazole-Induced Drug Eruption With Eosinophilia and Systemic Symptoms (DRESS).
Antia C, Persad L, Alikhan A
J Drugs Dermatol 2017 Oct 1;16(10):1043-1046. PMID: 29036260
Identifying prognostic factors for drug rash with eosinophilia and systemic symptoms (DRESS).
Wei CH, Chung-Yee Hui R, Chang CJ, Ho HC, Yang CH, Lin YJ, Chung WH
Eur J Dermatol 2011 Nov-Dec;21(6):930-7. doi: 10.1684/ejd.2011.1550. PMID: 21951554
Pharmacogenetics of cutaneous adverse drug reactions.
Aihara M
J Dermatol 2011 Mar;38(3):246-54. doi: 10.1111/j.1346-8138.2010.01196.x. PMID: 21342226
Clinicopathological features and prognosis of drug rash with eosinophilia and systemic symptoms: a study of 30 cases in Taiwan.
Chiou CC, Yang LC, Hung SI, Chang YC, Kuo TT, Ho HC, Hu S, Hong HS, Chung WH
J Eur Acad Dermatol Venereol 2008 Sep;22(9):1044-9. Epub 2008 Jul 4 doi: 10.1111/j.1468-3083.2008.02585.x. PMID: 18627428
Management of drug rash with eosinophilia and systemic symptoms (DRESS syndrome): an update.
Tas S, Simonart T
Dermatology 2003;206(4):353-6. doi: 10.1159/000069956. PMID: 12771485

Clinical prediction guides

DRESS syndrome induced by imatinib.
Kaur S, Singh S, Singh R, Singla P
J Postgrad Med 2021 Jul-Sep;67(3):158-163. doi: 10.4103/jpgm.JPGM_746_20. PMID: 34427280Free PMC Article
Drug reaction with eosinophilia and systemic symptoms: A single center descriptive observational study.
Sandhu S, Neema S, Vashisht D, Venugopal R, Sengupta P, Radhakrishnan S
Dermatol Ther 2021 Jan;34(1):e14670. Epub 2020 Dec 23 doi: 10.1111/dth.14670. PMID: 33314590
Cenobamate for the treatment of focal epilepsies.
Strzelczyk A, Mann C, Willems LM, Rosenow F, Bauer S
Expert Opin Pharmacother 2020 Dec;21(18):2215-2223. Epub 2020 Aug 19 doi: 10.1080/14656566.2020.1803830. PMID: 32812825
Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Induced by Imatinib.
Zgolli F, Aouinti I, Charfi O, Badri T, Elaidli S, Kastalli S, Lakhoua G, Zaïem A
Curr Drug Saf 2019;14(2):151-154. doi: 10.2174/1574886314666190130150243. PMID: 30706827
Identifying prognostic factors for drug rash with eosinophilia and systemic symptoms (DRESS).
Wei CH, Chung-Yee Hui R, Chang CJ, Ho HC, Yang CH, Lin YJ, Chung WH
Eur J Dermatol 2011 Nov-Dec;21(6):930-7. doi: 10.1684/ejd.2011.1550. PMID: 21951554

Recent systematic reviews

Immunopathogenic Insights on Preferential Human Herpesvirus-6 Reactivation in Drug Rash With Eosinophilia and Systemic Symptoms: A Scoping Review.
Zhu H, Ren V
J Cutan Med Surg 2023 Jul-Aug;27(4):388-398. Epub 2023 May 25 doi: 10.1177/12034754231177590. PMID: 37231539Free PMC Article
Management of Cutaneous Immune-Related Adverse Events in Patients With Cancer Treated With Immune Checkpoint Inhibitors: A Systematic Review.
Nadelmann ER, Yeh JE, Chen ST
JAMA Oncol 2022 Jan 1;8(1):130-138. doi: 10.1001/jamaoncol.2021.4318. PMID: 34709352
Methotrexate related cutaneous adverse drug reactions: a systematic literature review.
Zuber M, Harikrishna, Vidhyashree, Chhabra M, Venkataraman R, Kumar S, Rashid M
J Basic Clin Physiol Pharmacol 2022 Sep 1;33(5):549-565. Epub 2021 Oct 27 doi: 10.1515/jbcpp-2021-0165. PMID: 34706401
Ciprofloxacin-induced cutaneous adverse drug events: a systematic review of descriptive studies.
Kashyap A, Sreenivasan S, Rajan AK, Rashid M, Chhabra M
J Basic Clin Physiol Pharmacol 2021 Mar 16;33(3):327-346. doi: 10.1515/jbcpp-2020-0115. PMID: 33725760
Management of Psychotropic Drug-Induced DRESS Syndrome: A Systematic Review.
Bommersbach TJ, Lapid MI, Leung JG, Cunningham JL, Rummans TA, Kung S
Mayo Clin Proc 2016 Jun;91(6):787-801. Epub 2016 Apr 25 doi: 10.1016/j.mayocp.2016.03.006. PMID: 27126302

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