DRESS characteristics according to the causative medication

Chaabane, Amel; Romdhane, Haifa Ben; Fadhel, Najah Ben; Fredj, Nadia Ben; Ammar, Helmi; Boughattas, Naceur A.; Chadly, Zohra; Aouam, Karim

doi:10.1007/s00228-022-03353-8

Cited by 10 publications

(2 citation statements)

References 30 publications

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“…Antibiotics resulted in a lower rate of eosinophilia, shorter recovery time, and a lower RegiSCAR score. Allopurinol has been linked to severe kidney damage, whereas antibiotics have a short delay and a low RegiSCAR score [37]. In another study, the relationship between antiviral medications and DRESS was examined using data mining algorithms such as proportional reporting ratio (PRR) (≥2) with associated χ 2 value (>4), reporting odds ratio (ROR) (≥2) with 95% confidence interval, and case count (≥3).…”

Section: Discussionmentioning

confidence: 99%

ALDRESS: A Retrospective Pilot Study to Develop a Pharmacological Causality Algorithm for Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)

Stewart,

Gómez López de las Huertas,

Jiménez-González

et al. 2024

JCM

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Background: The drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome represents a severe form of drug hypersensitivity reaction characterized by significant morbidity, mortality, and long-term sequelae, coupled with limited therapeutic avenues. Accurate identification of the causative drug(s) is paramount for acute management, exploration of safe therapeutic alternatives, and prevention of future occurrences. However, the absence of a standardized diagnostic test and a specific causality algorithm tailored to DRESS poses a significant challenge in its clinical management. Methods: We conducted a retrospective case–control study involving 37 DRESS patients to validate a novel causality algorithm, the ALDRESS, designed explicitly for this syndrome, comparing it against the current standard algorithm, SEFV. Results: The ALDRESS algorithm showcased superior performance, exhibiting an 85.7% sensitivity and 93% specificity with comparable negative predictive values (80.6% vs. 97%). Notably, the ALDRESS algorithm yielded a substantially higher positive predictive value (75%) compared to SEFV (51.40%), achieving an overall accuracy rate of 92%. Conclusions: Our findings underscore the efficacy of the ALDRESS algorithm in accurately attributing causality to drugs implicated in DRESS syndrome. However, further validation studies involving larger, diverse cohorts are warranted to consolidate its clinical utility and broaden its applicability. This study lays the groundwork for a refined causality assessment tool, promising advancements in the diagnosis and management of DRESS syndrome.

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Section: Discussionmentioning

confidence: 99%

ALDRESS: A Retrospective Pilot Study to Develop a Pharmacological Causality Algorithm for Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)

Stewart,

Gómez López de las Huertas,

Jiménez-González

et al. 2024

JCM

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“…Furthermore, in the latest Spanish guidelines on management of DRESS syndrome, skin testing should be performed 2–6 months after recovery 6 . We also recently published our experience with DRESS syndrome, 36 in which skin tests were performed for almost all patients ( n = 85), at least 6 weeks after DRESS resolution. No flare up reaction has been objectified in these patients.…”

Section: Discussionmentioning

confidence: 99%

Drug reaction with eosinophilia and systemic symptoms in a paediatric population: Interest of skin tests

Ben Romdhane,

Fadhel,

Chadli

et al. 2023

Contact Dermatitis

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BackgroundDrug reaction with eosinophilia and systemic symptoms (DRESS) is a severe adverse drug reaction. It is uncommon in the paediatric population and can be difficult to diagnose as its initial symptoms may mimic a viral infection.ObjectiveTo analyse the features of paediatric DRESS and to evaluate the interest of skin tests in identifying the causative drugs.MethodsIt is a retrospective analysis (2004–2021) of DRESS cases diagnosed in paediatric patients. The DRESS diagnosis was defined using the RegiSCAR scoring. The skin tests were performed according to the ENDA recommendations.ResultsWe included 19 cases of DRESS occurred in 18 patients. Common clinical symptoms were exanthema and fever in 94.7% of cases each. The most commonly affected organ was the liver (84.2%). Among the implicated drugs, 16 were tested and skin tests were positive in 75%. To assess cross‐reactivity and co‐sensitization, skin tests with related and/or co‐administered drugs were performed in eight patients. Among them, only one child had positive results.ConclusionEarly diagnosis of DRESS and discontinuation of the incriminated drug might reduce the incidence of mortality in the paediatric population. Skin tests could be a safe and useful tool to identify the causative drug and assess cross‐reactivity.

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Multiple drugs

2022

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DRESS characteristics according to the causative medication

Cited by 10 publications

References 30 publications

ALDRESS: A Retrospective Pilot Study to Develop a Pharmacological Causality Algorithm for Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)

ALDRESS: A Retrospective Pilot Study to Develop a Pharmacological Causality Algorithm for Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)

Drug reaction with eosinophilia and systemic symptoms in a paediatric population: Interest of skin tests

Multiple drugs

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