Le « DRESS » syndrome aux antituberculeux

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome caused by first‐line antituberculosis drugs: Two case reports and a review of the literature

“…The only two cases in which pyrazinamide was successfully rechallenged are reported in References (Supporting Information Table S1). Ethambutol produced a positive skin test reaction in only three cases (our case 1, and two cases in Supporting Information Table S1), gave a negative skin test result in two patients (Supporting Information Table S1), and was responsible for a doubtful skin test result in our case 2. Ten other patients showed reactions when rechallenged with ethambutol (Supporting Information Table S1).…”

“…23 Patch tests seem to be performed only rarely, that is, in only 16 of 39 cases (our cases 1 and 2; Supporting Information Table S1. 3,7,14,17,18,21,24 ) False-negative reactions may occur, for example, because of patch tests being performed too early, 22 as shown by the experience with rifampicin in our first case, and pyrazinamide in our second case. Thus, besides patch tests not frequently being performed, and, whenever they are performed, potentially resulting in false-negative test reactions, in part explained by the sometimes (too) short time interval between resolution of skin lesions and performance of these tests, they can still be of value.…”

“…Rifampicin and isoniazid appear to be the most frequently involved molecules, having been identified as the culprit agent in 19 cases (our case 1, and 18 cases in Supporting Information Table S1 3,6-12 and 18 cases (our cases 1 and 2, and 16 cases in Supporting Information Table S1, 3,[6][7][8]11,[13][14][15][16][17][18] respectively. This equally applies to tuberculosis patients concomitantly infected with human immunodeficiency virus (HIV).…”

“…If allergological work‐up is performed, some patients are apparently investigated with prick and intradermal tests (with late readings) or, more often, even immediately through rechallenge tests, despite recommendations to avoid such high‐risk procedures in cases of severe adverse skin reactions such as DRESS syndrome . Patch tests seem to be performed only rarely, that is, in only 16 of 39 cases (our cases 1 and 2; Supporting Information Table S1 …”

Le DRESS syndrome secondaire aux antituberculeux: à propos d’un cas

“…Sur 172 cas de DRESS syndrome, 44 médicaments sont répertoriés avec un seul cas lié à la streptomycine [2]. En 2012, un cas du DRESS syndrome à l'éthambutol et à la rifampicine a été notifié [3] comme c'est le cas de notre observation, un autre cas de DRESS syndrome aux anti-bacillaires notamment à l'ethambutol et l'isoniazide avec un doute sur la rifampicine a été rapporté par Bouyad et al [4] et un autre cas a été noté par Iraqi et al [5] à l'éthambutol, à l'isoniazide et à la pyrazinamide. La majorité des patients présentant le DRESS syndrome ne sont initialement pas correctement diagnostiqués [6].…”