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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

Immune Reactions in Major Types of Oncological Treatment.
Kozubek P, Wołoszczak J, Gomułka K
Int J Mol Sci 2023 Jul 9;24(14) doi: 10.3390/ijms241411257. PMID: 37511017Free 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
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

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
Drug rash with eosinophilia and systemic symptoms (DRESS) in patients receiving strontium ranelate.
Cacoub P, Descamps V, Meyer O, Speirs C, Belissa-Mathiot P, Musette P
Osteoporos Int 2013 May;24(5):1751-7. Epub 2013 Jan 30 doi: 10.1007/s00198-013-2265-1. PMID: 23361875
Allopurinol-induced DRESS syndrome.
Markel A
Isr Med Assoc J 2005 Oct;7(10):656-60. PMID: 16259349

Diagnosis

Skin Testing Approaches for Immediate and Delayed Hypersensitivity Reactions.
Barbaud A, Romano A
Immunol Allergy Clin North Am 2022 May;42(2):307-322. Epub 2022 Mar 31 doi: 10.1016/j.iac.2022.01.003. PMID: 35469620
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
Vancomycin-associated Henoch-Schönlein purpura.
Min Z, Garcia RR, Murillo M, Uchin JM, Bhanot N
J Infect Chemother 2017 Mar;23(3):180-184. Epub 2016 Sep 25 doi: 10.1016/j.jiac.2016.08.012. PMID: 27681233
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
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
Vancomycin-associated Henoch-Schönlein purpura.
Min Z, Garcia RR, Murillo M, Uchin JM, Bhanot N
J Infect Chemother 2017 Mar;23(3):180-184. Epub 2016 Sep 25 doi: 10.1016/j.jiac.2016.08.012. PMID: 27681233
Allopurinol-induced DRESS syndrome.
Markel A
Isr Med Assoc J 2005 Oct;7(10):656-60. PMID: 16259349

Prognosis

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
Treatment of osteoporosis: recognizing and managing cutaneous adverse reactions and drug-induced hypersensitivity.
Musette P, Brandi ML, Cacoub P, Kaufman JM, Rizzoli R, Reginster JY
Osteoporos Int 2010 May;21(5):723-32. Epub 2009 Nov 17 doi: 10.1007/s00198-009-1097-5. PMID: 19921087
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
Drug-induced pseudolymphoma and drug hypersensitivity syndrome (Drug Rash with Eosinophilia and Systemic Symptoms: DRESS).
Bocquet H, Bagot M, Roujeau JC
Semin Cutan Med Surg 1996 Dec;15(4):250-7. doi: 10.1016/s1085-5629(96)80038-1. PMID: 9069593

Clinical prediction guides

Cutaneous and systemic hyperinflammation drives maculopapular drug exanthema in severely ill COVID-19 patients.
Mitamura Y, Schulz D, Oro S, Li N, Kolm I, Lang C, Ziadlou R, Tan G, Bodenmiller B, Steiger P, Marzano A, de Prost N, Caudin O, Levesque M, Stoffel C, Schmid-Grendelmeier P, Maverakis E, Akdis CA, Brüggen MC
Allergy 2022 Feb;77(2):595-608. Epub 2021 Jul 19 doi: 10.1111/all.14983. PMID: 34157151Free 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) in patients receiving strontium ranelate.
Cacoub P, Descamps V, Meyer O, Speirs C, Belissa-Mathiot P, Musette P
Osteoporos Int 2013 May;24(5):1751-7. Epub 2013 Jan 30 doi: 10.1007/s00198-013-2265-1. PMID: 23361875
Treatment of osteoporosis: recognizing and managing cutaneous adverse reactions and drug-induced hypersensitivity.
Musette P, Brandi ML, Cacoub P, Kaufman JM, Rizzoli R, Reginster JY
Osteoporos Int 2010 May;21(5):723-32. Epub 2009 Nov 17 doi: 10.1007/s00198-009-1097-5. PMID: 19921087

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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