Severe Cutaneous Adverse Reactions to Drugs in Latin America: The RACGRAD Study.
Adrenal Cortex Hormones
/ therapeutic use
Adult
Allergens
/ adverse effects
Anticonvulsants
/ adverse effects
Cross-Sectional Studies
Drug-Related Side Effects and Adverse Reactions
/ drug therapy
Female
Humans
Latin America
/ epidemiology
Male
Skin
/ pathology
Survival Analysis
beta-Lactams
/ adverse effects
Acute generalized exanthematous pustulosis
DRESS
Drug eruptions
Latin America
Stevens-Johnson syndrome
Toxic epidermal necrolysis
Journal
Journal of investigational allergology & clinical immunology
ISSN: 1018-9068
Titre abrégé: J Investig Allergol Clin Immunol
Pays: Spain
ID NLM: 9107858
Informations de publication
Date de publication:
26 Jul 2021
26 Jul 2021
Historique:
pubmed:
27
2
2020
medline:
15
12
2021
entrez:
27
2
2020
Statut:
ppublish
Résumé
Severe cutaneous adverse reactions to drugs (SCARs) are associated with high morbidity and mortality and with sequelae. Objective: To characterize patients with SCARs in 8 health care institutions in Latin America. We performed a cross-sectional, descriptive, multicenter study of patients diagnosed with SCARs in Latin America between January 2009 and December 2018. The analysis was carried out using a database in BD Clinic. We collected 70 patients, of whom 42 (60%) were women. Mean age was 38.7 years. Forty-two patients (60%) had DRESS-DIHS, 12 (17.1%) TEN, 5 (7.1%) SJS, 6 (8.5%) AGEP, 4 (5.7%) other reactions not classified as SCARs, and 1 (1.4%) overlapping SJS-TEN. The main causative drugs were aromatic anticonvulsants in 31 cases (44.3%), ß-lactam antibiotics in 11 cases (15.7%), and non-ß-lactam antibiotics in 6 cases (8.6%). In all of the cases, the suspected drug was withdrawn at the first sign of a SCAR. Sixty-six patients (94.2%) received anti-inflammatory treatment, mostly systemic corticosteroids. Complications occurred in 53 cases (75.7%), and 3 patients died (4.3%). Thirteen patients (18.6%) had sequelae. This is the first multicenter report on SCARs in Latin America. DRESS-DIHS was the most frequently reported clinical entity, and anticonvulsants were the main triggers. Most of the patients received systemic corticosteroids. Complications were frequent, and 3 patients died.
Sections du résumé
BACKGROUND AND OBJECTIVE
OBJECTIVE
Severe cutaneous adverse reactions to drugs (SCARs) are associated with high morbidity and mortality and with sequelae. Objective: To characterize patients with SCARs in 8 health care institutions in Latin America.
METHODS
METHODS
We performed a cross-sectional, descriptive, multicenter study of patients diagnosed with SCARs in Latin America between January 2009 and December 2018. The analysis was carried out using a database in BD Clinic.
RESULTS
RESULTS
We collected 70 patients, of whom 42 (60%) were women. Mean age was 38.7 years. Forty-two patients (60%) had DRESS-DIHS, 12 (17.1%) TEN, 5 (7.1%) SJS, 6 (8.5%) AGEP, 4 (5.7%) other reactions not classified as SCARs, and 1 (1.4%) overlapping SJS-TEN. The main causative drugs were aromatic anticonvulsants in 31 cases (44.3%), ß-lactam antibiotics in 11 cases (15.7%), and non-ß-lactam antibiotics in 6 cases (8.6%). In all of the cases, the suspected drug was withdrawn at the first sign of a SCAR. Sixty-six patients (94.2%) received anti-inflammatory treatment, mostly systemic corticosteroids. Complications occurred in 53 cases (75.7%), and 3 patients died (4.3%). Thirteen patients (18.6%) had sequelae.
CONCLUSIONS
CONCLUSIONS
This is the first multicenter report on SCARs in Latin America. DRESS-DIHS was the most frequently reported clinical entity, and anticonvulsants were the main triggers. Most of the patients received systemic corticosteroids. Complications were frequent, and 3 patients died.
Substances chimiques
Adrenal Cortex Hormones
0
Allergens
0
Anticonvulsants
0
beta-Lactams
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM