Drug Hypersensitivity Syndrome

Severe drug eruption characterized by high fever, erythematous rash and inflammation of internal organ(s).

Also Known As:

DRESS Syndrome; Drug Reaction with Eosinophilia and Systemic Symptoms; Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome; DRESS Syndromes; Drug Hypersensitivity Syndromes; Hypersensitivity Syndrome, Drug; Hypersensitivity Syndromes, Drug; Syndrome, Drug Hypersensitivity; Syndromes, Drug Hypersensitivity; Drug Reaction With Eosinophilia And Systemic Symptom

Networked: 815 relevant articles (17 outcomes, 27 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Exanthema (Rash)
2.	Drug Hypersensitivity Syndrome
3.	Eosinophilia
4.	Fever (Fevers)
5.	Acute Kidney Injury (Acute Renal Failure)

Experts

1.	Chung, Wen-Hung: 13 articles (12/2021 - 03/2005)
2.	Shiohara, Tetsuo: 12 articles (01/2022 - 08/2009)
3.	Asada, Hideo: 11 articles (01/2022 - 01/2015)
4.	Sukasem, Chonlaphat: 10 articles (12/2021 - 01/2016)
5.	Miyagawa, Fumi: 8 articles (01/2022 - 01/2015)
6.	Phillips, Elizabeth J: 8 articles (01/2022 - 03/2011)
7.	Klaewsongkram, Jettanong: 8 articles (12/2021 - 01/2016)
8.	Rerkpattanapipat, Ticha: 8 articles (12/2021 - 01/2016)
9.	Hung, Shuen-Iu: 8 articles (01/2021 - 03/2005)
10.	Mizukawa, Yoshiko: 7 articles (04/2022 - 08/2015)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Drug Hypersensitivity Syndrome:

1.	Adrenal Cortex Hormones (Corticosteroids)IBA 12/01/2022 - "Despite recent advances in the treatment of drug reaction with eosinophilia and systemic symptoms (DRESS), the mainstay of treatment involves discontinuing the culprit drugs and administering topical or systemic corticosteroid. " 07/20/2023 - "Corticosteroids are the first-line treatment for DRESS syndrome; however, corticosteroids may be contraindicated in certain patient populations. " 06/28/2023 - "DRESS syndrome induced by antituberculosis drugs is an atypical clinical reaction, similar to other types of DRESS syndrome that respond favorably to systemic corticosteroids. " 09/20/2023 - "The clinical presentation was DRESS syndrome in 8 patients, of whom 6 received corticosteroids. " 03/21/2023 - "Most cases of DRESS syndrome resolve with cessation of the inciting agent; however, use of systemic immunosuppression, most commonly with oral corticosteroids, is also recommended in cases with visceral organ involvement.We"
2.	Cyclosporine (Ciclosporin)FDA LinkGeneric 02/01/2023 - "Cyclosporine was discovered to be clinically effective in DRESS syndrome and this study suggests that cyclosporine could be a feasible primary therapeutic option for DRESS syndrome." 07/20/2023 - "Our study supports the use of cyclosporine in the treatment of DRESS syndrome, particularly in patients who are unable to sustain prolonged immunosuppression. " 07/20/2023 - "The aim of this case series was to examine the treatment of DRESS syndrome with cyclosporine in a large patient cohort by aggregating time to symptom resolution, recurrence rate, and treatment dose and duration. " 07/20/2023 - "There are currently only 54 cases detailing the use of cyclosporine for the treatment of DRESS syndrome reported in the literature. " 07/20/2023 - "Cyclosporine in the Treatment of Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome: Retrospective Cohort Study."
3.	SteroidsIBA 07/01/2023 - "Prompt treatment with high-dose steroids is essential in managing patients with severe symptoms associated with DRESS syndrome. " 07/01/2023 - "High-dose steroids were initiated as the treatment of choice for suspected DRESS syndrome. " 02/01/2023 - "She was diagnosed with drug reaction with eosinophilia and systemic symptoms (DRESS) and quickly started recovery after initiation of a high steroid substitution. " 01/01/2022 - "However, it is difficult to manage patients with DRESS syndrome who are not responsive to systemic steroids. " 09/01/2021 - "Impact of systemic to topical steroids switch on the outcome of drug reaction with eosinophilia and systemic symptoms (DRESS): A monocenter retrospective study of 20 cases."
4.	Anti-Bacterial Agents (Antibiotics)IBA 07/01/2021 - "• Early-onset DRESS syndrome is usually induced by antibiotics and appears ≤15 days after drug intake. " 08/15/2018 - "Our cases highlight that paediatricians should be aware of the clinical presentations of and therapeutic approaches for DRESS syndrome, especially in children receiving long-term antibiotic treatment. " 08/15/2018 - "We report two cases of DRESS syndrome due to prolonged antibiotic treatment in young children in whom recovery occurred following different therapeutic approaches. " 07/24/2018 - "Furthermore, it has been recently recognised that antibiotics may act as promoters of DRESS syndrome caused by another drug. " 01/01/2018 - "DRESS (drug reaction with eosinophilia and systemic symptoms) is a potentially serious complication when prolonged courses of antibiotics are given to patients, with an average onset of 2-6 weeks after commencement. "
5.	Sulfasalazine (Azulfidine)FDA LinkGeneric 09/01/2023 - "DRESS syndrome - A dermatological emergency - Sulfasalazine-related acute drug reaction case report." 08/19/2022 - "Drug hypersensitivity syndrome induced by sulfasalazine: A case report." 08/01/2020 - "[DRESS syndrome induced by sulfasalazine. " 03/01/2014 - "[DRESS syndrome following sulfasalazine treatment]." 09/01/2013 - "[Sulfasalazine-induced DRESS syndrome associated with Epstein Barr virus reactivation]."
6.	GlucocorticoidsIBA 02/25/2020 - "Over the next week, the patient deteriorated clinically with worsening transaminitis and oliguric acute renal failure requiring renal replacement therapy. As per the European Registry of Severe Cutaneous Adverse Reaction Criteria (RegiSCAR), the probability of rosuvastatin-induced DRESS syndrome was scored as "definite." He was treated with systemic and topical glucocorticoids leading to a gradual improvement in his symptoms. " 01/01/2022 - "She developed drug rash with eosinophilia and systemic symptoms (DRESS) syndrome after SMZ-TMP administration and improved after withdrawal of the culprit antibiotic and systemic glucocorticoids treatment. "
7.	Vancomycin FDA LinkGeneric 03/01/2012 - "This study highlights the importance of vancomycin as a cause of DRESS syndrome. " 09/20/2023 - "Vancomycin-induced liver injury is commonly associated with DRESS syndrome and linked to HLA-A∗32:01. " 09/20/2023 - "HLA typing demonstrated the HLA-A∗32:01 allele in 7 vancomycin cases (78%, all with DRESS syndrome), versus 1 of 81 cases (1.2%) exposed but not attributed to vancomycin, and 113 of 1708 cases (6.6%) without vancomycin exposure. " 12/01/2022 - "Risk Factors for Vancomycin Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome." 01/01/2020 - "Vancomycin-induced DRESS syndrome."
8.	Intravenous Immunoglobulins (IVIG)FDA Link 07/01/2018 - "Successful Intravenous Immunoglobulin Treatment in Pediatric Severe DRESS Syndrome." 01/01/2014 - "Clinical and laboratory improvement after intravenous immunoglobulin in drug reaction with eosinophilia and systemic symptoms." 04/01/2013 - "A case of recalcitrant DRESS syndrome with multiple autoimmune sequelae treated with intravenous immunoglobulins." 12/01/2022 - "A case of severe DRESS syndrome treated with therapeutic plasma exchange and intravenous immunoglobulin therapy." 01/01/2022 - "The addition of IVIG in DRESS syndrome in cases refractory to systemic steroid treatment may be helpful in hastening recovery. "
9.	Prednisone (Sone)FDA LinkGeneric 04/01/2014 - "Initial diagnostic tests were suggestive of drug hypersensitivity syndrome, and the patient's condition improved with treatment using oral prednisone. " 04/01/2022 - "The patient was diagnosed recurrent DRESS syndrome and restarted on a gradual prednisone taper with resolution over the following weeks. " 07/01/2012 - "However, within the next week DIHS/DRESS syndrome was diagnosed, which explained all the symptoms, and which was subsequently treated with prednisone and valganciclovir. " 07/01/2014 - "[Reversal of acute liver failure with N-acetylcysteine and prednisone in a patient with DRESS syndrome: a case report and literature review]." 07/01/2012 - "Treatment of DIHS/DRESS syndrome with combined N-acetylcysteine, prednisone and valganciclovir--a hypothesis."
10.	Prednisolone (Predate)FDA LinkGeneric 03/21/2023 - "Our patient experienced significant flare of symptoms of DRESS syndrome with multiple attempts to wean prednisolone. " 08/23/2023 - "We herein report a rare case of DRESS syndrome leading to hemodialysis and multiple infections with Pneumocystis pneumonia, cytomegalovirus and Aspergillus despite the administration of low-dose prednisolone. " 09/01/2023 - "The aim of this article is to summarize the literature finding regarding this dermatological emergency and present the case of a 42-year-old male suffering from DRESS syndrome as a consequence of sulfasalazine intake due to an inflammatory bowel disease, who was effectively treated with oral prednisolone and immediate drug withdrawal."

Therapies and Procedures

1.	Therapeutics 07/01/2023 - "Antitubercular therapy causing drug reaction with eosinophilia and systemic symptoms manifesting multi-organ dysfunction syndrome and death in an elderly patient: A case report with review of literature." 06/01/2022 - "DRESS syndrome due to first-line antitubercular therapy - A diagnostic imbroglio!" 03/01/2022 - "This atypical case highlights the importance of maintaining a flexible differential diagnosis in patients with suspected DRESS syndrome whose condition does not improve with appropriate drug withdrawal and therapy." 01/01/2021 - "A 13-question, scenario-based multiple-choice questionnaire to assess specific knowledge domains in drug hypersensitivity syndrome recognition, causality attribution, cross-reactivity patterns, appropriate diagnostic tests, and therapy was administered to HCPs of various vocation and specialty groups. " 06/01/2020 - "Dress syndrome secondary to different combinations of targeted therapy (iBRAF + iMEK)."
2.	Renal Replacement Therapy (Therapies, Renal Replacement) 09/01/2020 - "This is relevant acute kidney injury that develops in more than one-third of cases of DRESS syndrome with at least 10% of cases progressing to acute renal failure requiring renal replacement therapy. " 09/01/2020 - "Specifically, the authors argue that patients with DRESS syndrome complicated by acute kidney injury may benefit from utilization of specific forms of renal replacement therapy that also provide plasmapheresis. " 02/25/2020 - "Over the next week, the patient deteriorated clinically with worsening transaminitis and oliguric acute renal failure requiring renal replacement therapy. As per the European Registry of Severe Cutaneous Adverse Reaction Criteria (RegiSCAR), the probability of rosuvastatin-induced DRESS syndrome was scored as "definite." He was treated with systemic and topical glucocorticoids leading to a gradual improvement in his symptoms. " 07/01/2022 - "We report a case of 56-year-old patient with history of gout under allopurinol admitted in emergency for shock state associated erythematosquamous lesions reaching 65% of the body surface, a septic was suspected but the bacteriological investigations were negative and the patient had an isolated hyper eosinophilia so diagnosis of dress syndrome induced by allopurinol was retained The patient presented an acute renal failure that was treated successfully by renal replacement therapy, and corticosteroids. "
3.	Liver Transplantation 12/01/2020 - "Liver transplantation after DRESS syndrome: A case report and review of the literature." 12/01/2020 - "This study reports a patient with DRESS syndrome, associated with liver failure, treated with orthotopic liver transplantation." 10/01/2022 - "He presented a dress syndrome with fulminant liver failure that required a liver transplant. " 01/01/2021 - "Liver transplantation in a patient with fulminant hepatitis by DRESS syndrome." 11/30/2021 - "Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome in liver transplantation."
4.	Kidney Transplantation 01/01/2016 - "Herein, we report on a patient with DRESS syndrome who was scheduled for renal transplantation. " 08/01/2016 - "From January 2001 to August 2014, a total of 94 recipients with acute respiratory dress syndrome (ARDS) caused by pneumonia following kidney transplantation were enrolled in the present study. " 01/01/2016 - "Anesthetic Management of a Patient with DRESS Syndrome for Renal Transplantation."
5.	Aftercare (After-Treatment) 10/01/2022 - "Recurrence of DRESS syndrome is poorly characterized, and dermatologists must be prepared to predict, identify, and manage patients after treatment of the initial presentation. " 07/20/2023 - "DRESS syndrome's relapse after treatment with cyclosporine occurred in 3 of 19 (16%) occurrences of the cohort. " 01/01/2018 - "To report on 2 women with multiple sclerosis (MS) who developed severe neurologic deterioration and a drug reaction with eosinophilia and systemic symptoms (DRESS) after treatment with 2 and 4 subcutaneous injections of daclizumab, respectively. " 01/01/2012 - "Dress syndrome and acute tubulointerstitial nephritis after treatment with vancomycin and beta-lactams. "