Drug reaction with eosinophilia and systemic symptoms: Observations from a tertiary care institution

Sasidharanpillai, Sarita; Riyaz, Najeeba; Rajan, Uma; Binitha, Manikoth Payyanadan; Khader, Anza; Mariyath, Olasseri K Reena; John, Rajiv; Jayasree, Puravoor

doi:10.4103/0378-6323.132249

Cited by 21 publications

(33 citation statements)

References 11 publications

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“…This retrospective study is one of the largest pediatric DRESS series performed in the United States, characterizing the clinical and laboratory features of 10 pediatric inpatients. The male‐to‐female ratio was 3:2 which is consistent with the largest pediatric studies that report either a lack of gender predilection or a slight male predominance . The average age of diagnosis was 11.5 years old, which is similar to reported pediatric studies (mean age of 8.9‐11 years old) .…”

Section: Discussionsupporting

confidence: 87%

“…Understanding of DRESS in children is based upon case reports and small case series. The most commonly implicated drugs in children include antibiotics, namely trimethoprim‐sulfamethoxazole and vancomycin, followed by antiepileptic medications, such as lamotrigine, carbamazepine, and phenytoin . Ibuprofen, nevirapine, raltegravir, acetylsalicylic acid, griseofulvin, fluoxetine, and sulthiamine have been associated triggers in single pediatric case reports .…”

Section: Introductionmentioning

confidence: 99%

“…The most commonly implicated drugs in children include antibiotics, namely trimethoprim-sulfamethoxazole and vancomycin, followed by antiepileptic medications, such as lamotrigine, carbamazepine, and phenytoin. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Ibuprofen, nevirapine, raltegravir, acetylsalicylic acid, griseofulvin, fluoxetine, and sulthiamine have been associated triggers in single pediatric case reports. 3,[26][27][28][29][30][31] In addition, Sasidharanpillai et al found DRESS to occur more promptly after antibiotic therapy, averaging about one week after drug initiation, compared to over three weeks after antiepileptic therapy.…”

Section: Introductionmentioning

confidence: 99%

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Drug reaction with eosinophilia and systemic symptoms: Pediatric case series and literature review

Oberlin

Rahnama‐Moghadam

Alomari

et al. 2019

Pediatric Dermatology

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Background Pediatric Drug reaction with eosinophilia and systemic symptoms (DRESS) is an uncommon disease that can be difficult to diagnose. This case series and literature review highlights the clinical features of pediatric DRESS and underscores the differential diagnoses, culprit medications, and need for clinical follow‐up to detect associated autoimmune sequelae. Objective To describe the clinical and laboratory features of pediatric DRESS, identify associated culprit medications, and discuss the natural history of disease. Methods Ten cases of pediatric DRESS were identified in the electronic medical record by searching the inpatient dermatology consultation list at Indiana University between 2013 and 2018. Clinical and laboratory data were collected including demographics, differential diagnoses, culprit medications, resolution of disease, and autoimmune sequelae. Results Pediatric patients with DRESS presented at a mean age of 11.5 years and demonstrated a mean time from drug initiation to onset of symptoms of 4 weeks. The most common inciting drugs included antibiotics (62.5%) followed by antiepileptics (37.5%). Rash and transaminitis resolved by 3 weeks, and 20% of patients, all female, developed autoimmune sequelae including Hashimoto's thyroiditis and an undifferentiated connective tissue disorder and occurred at an average of 14.5 weeks after diagnosis. Limitations This was a small retrospective study of an uncommon clinical diagnosis at a single institution. Conclusions Pediatric DRESS was most commonly caused by antibiotics which are being increasingly recognized in the literature as the predominant culprit medications. The development of autoimmune sequelae is a notable consequence that can present weeks after illness and may preferentially affect female patients.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Drug reaction with eosinophilia and systemic symptoms: Pediatric case series and literature review

Oberlin

Rahnama‐Moghadam

Alomari

et al. 2019

Pediatric Dermatology

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“…Ten patients (90.9%) had internal organ involvement, manifesting as high liver transaminase levels in eight and pneumonitis in one. In addition to the high liver transaminase levels, one child had hepatosplenomegaly and renal function impairment .…”

Section: Resultsmentioning

confidence: 99%

“…Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe adverse drug reaction that has been reported in all age groups .…”

mentioning

confidence: 99%

Drug Reaction with Eosinophilia and Systemic Symptoms in Children: A Prospective Study

Sasidharanpillai

Sabitha

Riyaz

et al. 2016

Pediatric Dermatology

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Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe adverse drug reaction that can affect any age group. We carried out a prospective study of the clinicoepidemiologic aspects of DRESS in children. We prospectively studied all patients ages 12 years and younger admitted to the departments of pediatrics and dermatology at a tertiary care hospital over a 3-year period with probable or definite DRESS, defined based on the RegiSCAR scoring system. A total of 11 patients were studied. Lamotrigine (four patients) and pencillins (three patients) were the most common offending drugs. Not adhering to the standard guidelines of introduction and gradual titration of lamotrigine to therapeutic dose may have increased the chance of lamotrigine-induced DRESS. A short latent period between the onset of drug intake and drug reaction was noted in DRESS induced by antibiotics.

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Multiple drugs

2014

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Drug reaction with eosinophilia and systemic symptoms: Observations from a tertiary care institution

Cited by 21 publications

References 11 publications

Drug reaction with eosinophilia and systemic symptoms: Pediatric case series and literature review

Drug reaction with eosinophilia and systemic symptoms: Pediatric case series and literature review

Drug Reaction with Eosinophilia and Systemic Symptoms in Children: A Prospective Study

Multiple drugs

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