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DRESS characteristics according to the causative medication
A Chaabane1, H Ben Romdhane1, N Ben Fadhel1
1Service de Pharmacologie Clinique, CHU/Faculté de Médecine, Université de Monastir, Rue 1er Juin 1955, 5019, Monastir, Tunisia.
European Journal of Clinical Pharmacology
|June 21, 2022
Summary
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) presentation varies by causative drug. Anticonvulsants, allopurinol, and antibiotics show distinct clinical patterns and outcomes in DRESS patients.
Area of Science:
- Clinical Pharmacology
- Dermatology
- Nephrology
Background:
- The relationship between specific drugs and clinical DRESS manifestations remains unclear.
- Identifying distinct DRESS patterns linked to causative agents is crucial for diagnosis and management.
Purpose of the Study:
- To investigate the specific characteristics of DRESS.
- To analyze how DRESS patterns vary based on the implicated drug.
Main Methods:
- Retrospective analysis of DRESS cases reported over 15 years.
- Statistical analysis including comparative and multivariate methods.
Main Results:
- Anticonvulsants, allopurinol, and antibiotics were the most common DRESS inducers.
- Distinct patterns emerged: anticonvulsants (higher lymphadenopathy, frequent positive skin tests), allopurinol (older patients, less severe renal/lymph node involvement), antibiotics (lower eosinophilia, faster recovery, lower RegiSCAR score).
- Multivariate analysis linked allopurinol to severe renal impairment, antibiotics to short latency/low RegiSCAR, and anticonvulsants to positive skin tests.
Conclusions:
- This study presents the largest African and South Mediterranean DRESS cohort.
- Skin tests are valuable for identifying culprit drugs in DRESS.
- Latency period and renal involvement in DRESS are independently influenced by the causative drug.
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