Drug reaction with eosinophilia and systemic symptoms may occur within 2 weeks of drug exposure: A retrospective study - 11/02/20
, Claire Bernier, MD c, Gwenaelle Veyrac, MD d, Annick Barbaud, MD, PhD a, Etienne Puymirat, MD, PhD e, Brigitte Milpied, MD fAbstract |
Background |
Diagnosing drug reaction with eosinophilia and systemic symptoms (DRESS) is challenging. Some clinicians reject this diagnosis when the delay of onset is less than 15 days after drug intake.
Objectives |
To assess the delay of DRESS occurrence and culprit drugs.
Methods |
All patients hospitalized in 3 dermatology departments with a first occurrence of DRESS for which a drug was highly suspected were included in this retrospective study. Based on the delay in DRESS occurrence, cases were classified into 2 groups: a rapid-onset group (≤15 days after exposure) and a delayed-onset group (>15 days).
Results |
A total of 41 patients with DRESS were included: 14 in the rapid-onset and 27 in delayed-onset groups. In the rapid-onset group, antibiotics (n = 6/14) and iodinated contrast media (n = 5/5) were the predominant culprits. Carbamazepine (n = 4/4), lamotrigine (n = 6/6), allopurinol (n = 8/8), and sulfasalazine (n = 2/2) were exclusively found in the delayed-onset group.
Limitations |
The retrospective nature, limited number of participants, and lack of detailed information on previous exposure to sensitizing drugs in some instances.
Conclusions |
DRESS is frequently related to drugs introduced 15 or fewer days before the occurrence of cutaneous adverse reactions. The time of onset of DRESS may differ depending on the medications involved.
Le texte complet de cet article est disponible en PDF.Key words : allopurinol, antibiotics, carbamazepine, delay of occurrence, diagnosis criteria, DRESS, drug allergy, iodinated contrast media, lamotrigine
Abbreviations used : DHIS, DRESS, RegiSCAR
Plan
| Funding sources: None. |
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| Conflicts of interest: None disclosed. |
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| IRB approval status: Not required for this retrospective noninterventional study. |
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| Reprints not available from the authors. |
Vol 82 - N° 3
P. 606-611 - mars 2020 Retour au numéro
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