ReviewThe DRESS Syndrome: A Literature Review
Section snippets
Materials and Methods
A systematic review of DRESS cases reported in the literature was carried out by searching PubMed-MEDLINE between January 1997 and May 2009. Search terms were “DRESS syndrome,” “drug reaction with eosinophilia and systemic symptoms,” “drug rash with eosinophilia and systemic symptoms,” “drug hypersensitivity and eosinophilia,” and “drug-induced hypersensitivity syndrome.” Publications were limited to the English and French languages.
We used the RegiSCAR's scoring system recently published to
Results
From a total of 131 independent published reports, 172 cases of DRESS were analyzed. Publications were excluded from analysis when they displayed data group summaries in which data could not be fully analyzed because the results were not assigned to a specific patient (Figure).
The drugs associated with DRESS and the distribution of the cases after RegiSCAR's score assignment are displayed in Table 2.12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35,
Discussion
In this review, we have done an extended analysis of 172 cases reported as DRESS or drug hypersensitivity syndrome in the literature by using the RegiSCAR scoring system.11
This review shows that DRESS is challenging to diagnose. Patients defined by the scoring system as “no/possible” cases of DRESS accounted for approximately one quarter of all the DRESS cases reported in the literature. However, cases classified as “probable/definite” by the RegiSCAR scoring system represented the vast
References (145)
- et al.
DRESS syndrome associated with HHV-6 reactivation
Eur J Intern Med
(2003) - et al.
Human herpesvirus 6 reactivation and inflammatory cytokine production in patients with drug-induced hypersensitivity syndrome
J Clin Virol
(2006) - et al.
Atorvastatin-induced drug reaction with eosinophilia and systemic symptoms (DRESS) [French]
Ann Dermatol Venereol
(2009) - et al.
Drug-induced hypersensitivity syndrome: drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome induced by aspirin treatment of Kawasaki disease
J Am Acad Dermatol
(2009) - et al.
Fever, eosinophilia, and a rash
J Am Acad Dermatol
(2006) - et al.
Detection of human herpesvirus-6 transcripts in carbamazepine-induced hypersensitivity syndrome by in situ hybridization
J Dermatol Sci
(2009) - et al.
Case reports and literature review: the association between reactivation of human herpes virus-6 and peripheral white blood cell count in patients with carbamazepine-induced hypersensitivity syndrome
Prog Neuropsychopharmacol Biol Psychiatry
(2006) - et al.
Eosinophilic esophagitis is a component of the anticonvulsant hypersensitivity syndrome: description of two cases
Dig Liver Dis
(2008) - et al.
Successful treatment with gabapentin in the presence of hypersensitivity syndrome to phenytoin and carbamazepine: a report of three cases
Seizure
(1999) - et al.
Hepatotoxicity of carbamazepine: a case of “DRESS syndrome” [French]
Gastroenterol Clin Biol
(2007)
DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) syndrome after sulfasalazine and carmazepine: report of two cases [French]
Rev Med Interne
Clomipramine-induced hypersensitivity syndrome with unusual clinical features
J Am Acad Dermatol
Clopidogrel hypersensitivity syndrome with rash, fever, and neutropenia
Mayo Clin Proc
Hydroxychloroquine and DRESS [French]
Ann Dermatol Venereol
Fulminant type 1 diabetes mellitus caused by drug hypersensitivity syndrome with human herpesvirus 6 infection
J Am Acad Dermatol
Drug reaction with eosinophilia and systemic symptoms (DRESS) following imatinib therapy [French]
Ann Dermatol Venereol
Lamotrigine-associated anticonvulsant hypersensitivity syndrome in bipolar disorder
Prog Neuropsychopharmacol Biol Psychiatry
Dress syndrome and fulminant hepatic failure induced by lamotrigine
Ann Hepatol
DRESS syndrome with bilateral panuveitis, elevated intraocular pressure, and HHV-6 reactivation: a case report [French]
J Fr Ophtalmol
Mexiletine-induced severe skin eruption, fever, eosinophilia, atypical lymphocytosis, and liver dysfunction
Pain
Severe drug rash with eosinophilia and systemic symptoms after treatment with minocycline [French]
Rev Mal Respir
A 6-month prospective survey of cutaneous drug reactions in a hospital setting
Br J Dermatol
Drug-induced pseudolymphoma and drug hypersensitivity syndrome (Drug Rash with Eosinophilia and Systemic Symptoms: DRESS)
Semin Cutan Med Surg
Severe adverse cutaneous reactions to drugs
N Engl J Med
Anticonvulsant hypersensitivity syndromeIn vitro assessment of risk
J Clin Invest
Association of human herpesvirus 6 infection with drug reaction with eosinophilia and systemic symptoms
Arch Dermatol
Drug reaction with eosinophilia and systemic symptoms (DRESS): a multiorgan antiviral T cell response
Sci Transl Med
Association of human herpesvirus 6 reactivation with the flaring and severity of drug-induced hypersensitivity syndrome
Br J Dermatol
DIDMOHS: a proposed consensus nomenclature for the drug-induced delayed multiorgan hypersensitivity syndrome
Arch Dermatol
The diagnosis of a DRESS syndrome has been sufficiently established on the basis of typical clinical features and viral reactivations
Br J Dermatol
Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist?
Br J Dermatol
Severe abacavir hypersensitivity reaction in a patient tested HLA-B*5701 negative
AIDS
Abacavir-induced reaction with fever and severe skin rash in a patient tested human leukocyte antigen-B*5701 negative
Int J STD AIDS
An unusual abacavir reaction
AIDS
Abacavir hypersensitivity reaction after switching from the twice-daily to the once-daily formulation
AIDS Patient Care STDS
Agranulocytosis and fever seven weeks after starting abacavir
AIDS
Allopurinol-induced DRESS syndrome in a 13-year-old girl
J Investig Allergol Clin Immunol
Reactivation of human herpesvirus (HHV) family members other than HHV-6 in drug-induced hypersensitivity syndrome
Br J Dermatol
Human herpesvirus 6 infection as a risk factor for the development of severe drug-induced hypersensitivity syndrome
Arch Dermatol
Allopurinol hypersensitivity syndrome and acute myocardial infarction—two case reports
Ann Acad Med Singapore
Human herpes virus 6 encephalitis in allopurinol-induced hypersensitivity syndrome
Acta Derm Venereol
Allopurinol hypersensitivity syndrome: hypersensitivity to oxypurinol but not allopurinol
Clin Exp Dermatol
Fatal allopurinol hypersensitivity syndrome after treatment of asymptomatic hyperuricaemia
BMJ
Hypersensitivity syndrome and pure red cell aplasia following allopurinol therapy in a patient with chronic kidney disease
Ann Pharmacother
Drug-induced hypersensitivity syndrome associated with Epstein-Barr virus infection
Br J Dermatol
Allopurinol induced DRESS syndrome [French]
Rev Med Interne
Allopurinol-induced recurrent DRESS syndrome: pathophysiology and treatment
Ren Fail
Drug-induced hypersensitivity syndrome with rapid hematopoietic reconstitution during treatment for acute myeloid leukemia
Haematologica
Association of DRESS syndrome with chylous ascites
Nephrol Dial Transplant
Phenytoin hypersensitivity syndrome with positive patch testA possible cross-reactivity with amitriptyline
J Investig Allergol Clin Immunol
Cited by (0)
Funding: This work was funded by Institut de Recherche Internationale Servier.
Conflict of Interest: Pr. Jean Claude Roujeau has provided punctual advice on cases of adverse reactions to drugs from more than 15 different pharmaceutical companies in the past 20 years. He has served as an expert on 3 trials related to severe drug reactions in US Courts. He is a member of advisory boards on Severe Cutaneous Adverse Reactions for Pfizer (2002-2007), Vertex (2008-ongoing), Servier (2008-ongoing), Boehringer Ingelheim (2010-ongoing), Roche (2010-ongoing). He has participated in the RegiSCAR research group, funded in part by several pharmaceutical companies (detailed list provided in publications by the RegiSCAR group, eg, Sassolas B et al. Clin Pharmacol Ther. 2010;88[1]:60-8). No other authors have any conflicts of interest to report.
Authorship: All authors had access to the data and played a role in writing this manuscript.