Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms severity score: A useful tool for assessing disease severity and predicting fatal cytomegalovirus disease - 11/02/19
, Kazuhisa Hirahara, MD, PhD a, b, Yoko Kano, MD, PhD a, Tetsuo Shiohara, MD, PhD aAbstract |
Background |
The prognosis of drug-induced hypersensitivity syndrome (DiHS)/drug reaction with eosinophilia and systemic symptoms (DRESS) is highly unpredictable. Severe complications, either related or unrelated to cytomegalovirus (CMV) reactivation, are a highly probable cause of death.
Objectives |
The aim was to establish a scoring system for DiHS/DRESS that can be used to monitor severity, predict prognosis, and stratify the risk of developing CMV disease and complications.
Methods |
A retrospective analysis of 55 patients with DiHS/DRESS was performed. A composite score was created using clinical data. DiHS/DRESS patients were also stratified into 3 groups based on the scores to predict the risk of CMV reactivation and complications.
Results |
This scoring system made it possible to predict CMV disease and complications. Scores ≥4 were associated with the later development of CMV disease and complications, while no patients with scores <4 developed complications.
Limitations |
This was a single-institution study with a relatively small patient cohort that lacked a validation cohort.
Conclusions |
Our scoring system may be useful for predicting CMV-related complications, and early intervention with anti-CMV agents should be considered in patients with scores ≥4 or with evidence of CMV reactivation.
Le texte complet de cet article est disponible en PDF.Key words : CMV reactivation, disease severity, drug-induced hypersensitivity syndrome (DiHS)/drug reaction with eosinophilia and systemic symptoms (DRESS), prognosis, scoring system
Plan
| Supported in part by grants from the Ministry of Education, Culture, Sports, Science and Technology and the Health and Labour Sciences Research Grants (Research on Intractable Diseases) from the Ministry of Health, Labour and Welfare, Japan (Dr Shiohara). |
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| Conflicts of interest: None disclosed. |
Vol 80 - N° 3
P. 670 - mars 2019 Retour au numéro
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