Hepatic manifestations of drug reaction with eosinophilia and systemic symptoms syndrome

Delgado, María Gabriela; Casu, Stefania; Montani, M.; Brunner, Felix; Semmo, Nasser; Berzigotti, Annalisa; Dufour, Jean–François

doi:10.37349/emed.2021.00037

Cited by 2 publications

(3 citation statements)

References 32 publications

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“…This review identified antibiotics as the drug class most frequently causing DS, with vancomycin being the most common. Similar findings of antibiotics as the most common class of medication associated with DS were observed in other retrospective studies [98,100], a case series [101], and in recent literature reviews [8,99]. Allopurinol, which was associated with a higher risk of renal involvement in some studies [85,90], is the second most common causative agent of DS in this review.…”

Section: Causative Drugs and Latencysupporting

confidence: 89%

“…Allopurinol, which was associated with a higher risk of renal involvement in some studies [85,90], is the second most common causative agent of DS in this review. Interestingly, anticonvulsants appeared as the third most common in our review, and in many previous studies, it was identified as the main causative class [89,95,96,[101][102][103]. It remains to be answered in future studies if certain medication classes have the predisposition to cause particular visceral manifestations of DS.…”

Section: Causative Drugs and Latencymentioning

confidence: 66%

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Renal Manifestations of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome: A Systematic Review of 71 Cases

Dagnon da Silva,

Domingues,

Oluic

et al. 2023

JCM

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Unlike other adverse drug reactions, visceral organ involvement is a prominent feature of drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome and correlates with mortality. The aim of this study was to systematically review cases published in PubMed-indexed, peer-reviewed journals in which patients had renal injury during the episode of DRESS syndrome (DS). We found 71 cases, of which 67 were adults and 56% were males. Female sex was associated with higher mortality. Chronic kidney disease (CKD) was present in 14% of patients who developed acute kidney injury (AKI) during DS. In 21% of cases, the kidneys were the only visceral organ involved, while 54% of patients had both liver and kidney involvement. Eosinophilia was absent in 24% of patients. The most common classes of medication associated with renal injury in DS were antibiotics in 34%, xanthine oxidase inhibitors in 15%, and anticonvulsants in 11%. Among antibiotics, vancomycin was the most common culprit in 68% of patients. AKI was the most common renal manifestation reported in 96% of cases, while isolated proteinuria or hematuria was present in only 4% of cases. In cases with AKI, 88% had isolated increase in creatinine and decrease in glomerular filtration (GFR), 27% had AKI concomitantly with proteinuria, 18% had oliguria, and 13% had concomitant AKI with hematuria. Anuria was the rarest manifestation, occurring in only 4% of patients with DS. Temporary renal replacement therapy was needed in 30% of cases, and all but one patient fully recovered renal function. Mortality of DS in this cohort was 13%, which is higher than previously reported. Medication class, latency period, or pre-existing CKD were not found to be associated with higher mortality. More research, particularly prospective studies, is needed to better recognize the risks associated with renal injury in patients with DS. The development of disease-specific biomarkers would also be useful so DS with renal involvement can be easier distinguished from other eosinophilic diseases that might affect the kidney.

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Section: Causative Drugs and Latencysupporting

confidence: 89%

Section: Causative Drugs and Latencymentioning

confidence: 66%

Renal Manifestations of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome: A Systematic Review of 71 Cases

Dagnon da Silva,

Domingues,

Oluic

et al. 2023

JCM

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“…It is described that patients with severe acute liver damage may shows an overall survival of 75%, with hepatic encephalopathy, factor V level, prothrombin time were predictors of poor prognosis. 9 Lung involvement from DRESS may decrease lung capacity as this condition may take form as acute interstitial pneumonitis, lymphocytic interstitial pneumonia, pleuritis, and acute respiratory distress syndrome (ARDS). Lung involvement may also be described by signs such as cough, dyspnea, pleuritic pain and/or radiological findings such as unilateral or bilateral pulmonary infiltrates, lobar infiltrates, and pulmonary nodules.…”

Section: Discussionmentioning

confidence: 99%

Differential Diagnosis of Fever of Unknown Origin in Drug Reaction with Eosinophilia and Systemic Symptom (DRESS)

Muhammad

Ferdian

Rahmadi

2022

ijihs

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Objective: To describe an unusual case of drug reaction with eosinophilia and systemic symptoms presenting as fever of unknown origin (FUO) and the diagnostic hurdles that come with the presence of differential diagnosis of FUO, which is tuberculous lymphadenitis. Methods: A 34-year-old female with a chief complaint of fever that has lasted for 3 weeks accompanied with jaundice and skin rashes for 2 weeks was admitted with an indication of FUO. She had a history of carbamazepine consumption for trigerminal neuralgia 2 months prior. Cervical lymphadenopathy was palpable bilaterally and hepatomegaly, elevated liver enzyme, as well as hyperbilirubinemia were observed. After excluding differentials for many causes of prolonged fever, patient was treated for Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) and was given intravenous steroid injections. Fine needle aspiration biopsy was performed for her cervical lymphadenopathy. Results: Biopsy presented a mix of sialadenitis and tuberculous lymphadenopathy. Clinical improvement was observed on the second day after steroid administration. Patient was discharged on the seventh day after steroid administration. Conclusion: FUO is one of the possible manifestations of DRESS; however, thorough investigation still needed to be done considering the possibility of more than one entity of disease that can cause FUO in patients, such as tuberculous lymphadenopathy seen in this case.

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Hepatic manifestations of drug reaction with eosinophilia and systemic symptoms syndrome

Cited by 2 publications

References 32 publications

Renal Manifestations of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome: A Systematic Review of 71 Cases

Renal Manifestations of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome: A Systematic Review of 71 Cases

Differential Diagnosis of Fever of Unknown Origin in Drug Reaction with Eosinophilia and Systemic Symptom (DRESS)

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