Ten cases of drug reaction with eosinophilia and systemic symptoms (DRESS) treated with pulsed intravenous methylprednisolone

Drug reaction with eosinophilia and systemic symptoms: is cutaneous phenotype a prognostic marker for outcome? A review of clinicopathological features of 27 cases

“…5,6 The demonstration of prognostic indicators would help identify patients benefiting from intervention with potent therapy and rapid transfer to an intensive care unit. 12 In this study, 27 patients with DRESS underwent assessment of their cutaneous signs and dermatopathological features. In order to identify potential prognostic markers, we looked for clinical or pathological signs that were over-represented in those with severe liver involvement.…”

“…Although authors have observed that pancytopenia and certain medications may be associated with increased mortality, currently there are no recognized phenotypic markers of disease severity in DRESS, and therefore no mechanism by which outcome can be predicted 5,6 . The demonstration of prognostic indicators would help identify patients benefiting from intervention with potent therapy and rapid transfer to an intensive care unit 12 …”

Drug reaction with eosinophilia and systemic symptoms: a clinicopathological study of six cases at a teaching hospital in midwestern Brazil

“…Despite a published consensus that withdrawal of suspected drugs is indicated in cases of cutaneous reaction, the benefits of therapy with systemic corticosteroids in cases of DRESS/DIHS remain controversial . Good results with pulse methylprednisolone therapy were reported from a prospective study conducted in London . However, a recent Korean investigation concluded that corticosteroids have no effect on the duration of eruptions, mortality, or time for recovery from liver dysfunction .…”

“…15,18 Good results with pulse methylprednisolone therapy were reported from a prospective study conducted in London. 24 However, a recent Korean investigation concluded that corticosteroids have no effect on the duration of eruptions, mortality, or time for recovery from liver dysfunction. 18 Despite the need for further randomized and controlled studies of treatment options for the syndrome, systemic corticosteroids have been consistently prescribed in cases of severe hypersensitivity reaction to drugs.…”

Allopurinol induced DRESS syndrome without eosinophilia and pronounced mucosal involvement

“…Rapid tapering leads to relapse of symptoms; therefore slow dose reduction is advised. 2 Pulsed intravenous methylprednisolone seems to be efficient, 9 in contrast to intravenous immunoglobuline (IVIG), 5 although no controlled studies for IVIG exist for DRESS. Relapses as incomplete DRESS caused by structurally unrelated culprit drugs are frequently described.…”