DRESS characteristics according to the causative medication.
DRESS
Hypersensitivity
Pharmacovigilance
Skin tests
Journal
European journal of clinical pharmacology
ISSN: 1432-1041
Titre abrégé: Eur J Clin Pharmacol
Pays: Germany
ID NLM: 1256165
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
06
12
2021
accepted:
08
06
2022
pubmed:
22
6
2022
medline:
13
8
2022
entrez:
21
6
2022
Statut:
ppublish
Résumé
To date, no study has identified a clear relationship between drug and a specific clinical presentation of DRESS. To investigate the particularities of DRESS and analyze the variation of DRESS pattern according to culprit drugs. We analyzed cases of DRESS notified to the Department of Clinical Pharmacology at the University Hospital of Monastir over a 15-year period. The statistical study was performed using the comparative and multivariate analysis. DRESS was mostly induced by anticonvulsive agents (27%) followed by allopurinol (26.3%) and antibiotics (24%): For anticonvulsive agents, the occurrence of lymphadenopathy was higher, renal involvement was rare and mild, and positive skin tests were more frequent. The allopurinol group was associated with the patient's older age and a lower incidence of lymphadenopathy and kidney injury. For antibiotics, eosinophilia rate was lower, time to recovery was shorter, and RegiSCAR score was low. The multivariate analysis showed a link of allopurinol with severe renal impairment, antibiotics with short latency period and low RegiSCAR score, and anticonvulsants with high propensity of positive skin test. We report the largest African and south Mediterranean cohort of DRESS and evaluated the usefulness of skin tests in identifying the culprit drug. The prominent finding was that latency period and renal involvement may independently differ according to culprit drugs.
Sections du résumé
BACKGROUND
BACKGROUND
To date, no study has identified a clear relationship between drug and a specific clinical presentation of DRESS.
OBJECTIVES
OBJECTIVE
To investigate the particularities of DRESS and analyze the variation of DRESS pattern according to culprit drugs.
METHODS
METHODS
We analyzed cases of DRESS notified to the Department of Clinical Pharmacology at the University Hospital of Monastir over a 15-year period. The statistical study was performed using the comparative and multivariate analysis.
RESULTS
RESULTS
DRESS was mostly induced by anticonvulsive agents (27%) followed by allopurinol (26.3%) and antibiotics (24%): For anticonvulsive agents, the occurrence of lymphadenopathy was higher, renal involvement was rare and mild, and positive skin tests were more frequent. The allopurinol group was associated with the patient's older age and a lower incidence of lymphadenopathy and kidney injury. For antibiotics, eosinophilia rate was lower, time to recovery was shorter, and RegiSCAR score was low. The multivariate analysis showed a link of allopurinol with severe renal impairment, antibiotics with short latency period and low RegiSCAR score, and anticonvulsants with high propensity of positive skin test.
CONCLUSION
CONCLUSIONS
We report the largest African and south Mediterranean cohort of DRESS and evaluated the usefulness of skin tests in identifying the culprit drug. The prominent finding was that latency period and renal involvement may independently differ according to culprit drugs.
Identifiants
pubmed: 35726027
doi: 10.1007/s00228-022-03353-8
pii: 10.1007/s00228-022-03353-8
doi:
Substances chimiques
Anti-Bacterial Agents
0
Anticonvulsants
0
Allopurinol
63CZ7GJN5I
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1503-1510Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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