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Conference Paper: Drug reaction with eosinophilia and systemic symptoms (DRESS): a retrospective analysis of 21 cases in a tertiary teaching hospital in Hong Kong.

TitleDrug reaction with eosinophilia and systemic symptoms (DRESS): a retrospective analysis of 21 cases in a tertiary teaching hospital in Hong Kong.
Authors
KeywordsMedical sciences
Dermatology and venereology
Issue Date2012
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/jaad
Citation
The 70th Annual Scientific Meeting of the American Academy of Dermatology (AAD 2012), San Diego, CA., 16-20 March 2012. In Journal of American Academy of Dermatology, 2012, v. 66 n. 4, suppl. 1, p. AB129, poster no. 5215 How to Cite?
AbstractBACKGROUND: Drug reaction with eosinophilia and systemic symptoms (DRESS) is an acute, distinct and severe idiosyncratic reaction with a mortality of 8% to 10%. Owing to the rarity of the syndrome, large-scale studies are limited. Important data including the pattern of etiological agents, clinical and biochemical features and prognosis are lacking. OBJECTIVE: To investigate the demographic data, clinical and biochemical characteristics, causative agents, treatment, and outcome of cases of DRESS in Hong Kong. METHODS: A single center retrospective study on 21 cases of DRESS from February 2007 to February 2011. Medical records, clinical photographs, and sequential laboratory data were reviewed. An attempt was made to identify any correlation among the clinical pattern and specific causative agents. MAIN OUTCOME MEASURES: Clinical and biochemical pattern for specific drugs, treatment outcome and prognosis of DRESS. RESULTS: Age of onset ranged from 14 to 77. No sex predilection was observed. The most common offending drug was allopurinol (28.6%), followed by phenobarbitone and trimethoprim-sulfamethoxazole. Mean latency period was 21.6 days. Exanthematous eruption was the most common cutaneous manifestation. Fever, hepatitis and eosinophilia were present in all cases. Renal impairment was observed in 7 patients (33.3%). Allopurinol-induced DRESS was associated with a higher frequency of preexisting renal insufficiency (P = .02) and increased risk of renal involvement as part of the syndrome (P = .002). Lichenoid dermatitis was the most common histopathologic feature. Systemic corticosteroid was commenced in 15 cases (71.4%). The average initial dose was 54.6 mg/day (0.95 mg/kg/day). The mean duration of corticosteroid use was 33 weeks. Steroid-sparing agents were used in 7 cases. Two cases in the case series developed autoimmune thyroiditis and one case developed bronchiolitis obliterans organizing pneumonia on subsequent follow-ups. The overall mortality was 4.8%. Prolonged erythroderma were observed in 2 cases induced by trimethoprim-sulfamethoxazole. CONCLUSION: DRESS is a form of severe cutaneous adverse reaction and associated with a variety of clinical and biochemical features. Allopurinol is a common causative agent of DRESS and its use in patients with pre-existing renal insufficiency should be cautiously monitored. Copyright © 2012 Published by Mosby, Inc.
DescriptionThis journal suppl. entitled: Poster Abstracts, American Academy of Dermatology 70th Annual Meeting
Poster Session - Internal Medicine Dermatology: poster no. 5215
Persistent Identifierhttp://hdl.handle.net/10722/199421
ISSN
2015 Impact Factor: 5.621
2015 SCImago Journal Rankings: 2.242

 

DC FieldValueLanguage
dc.contributor.authorChan, JCYen_US
dc.contributor.authorYeung, CKen_US
dc.date.accessioned2014-07-22T01:17:00Z-
dc.date.available2014-07-22T01:17:00Z-
dc.date.issued2012-
dc.identifier.citationThe 70th Annual Scientific Meeting of the American Academy of Dermatology (AAD 2012), San Diego, CA., 16-20 March 2012. In Journal of American Academy of Dermatology, 2012, v. 66 n. 4, suppl. 1, p. AB129, poster no. 5215en_US
dc.identifier.issn0190-9622-
dc.identifier.urihttp://hdl.handle.net/10722/199421-
dc.descriptionThis journal suppl. entitled: Poster Abstracts, American Academy of Dermatology 70th Annual Meeting-
dc.descriptionPoster Session - Internal Medicine Dermatology: poster no. 5215-
dc.description.abstractBACKGROUND: Drug reaction with eosinophilia and systemic symptoms (DRESS) is an acute, distinct and severe idiosyncratic reaction with a mortality of 8% to 10%. Owing to the rarity of the syndrome, large-scale studies are limited. Important data including the pattern of etiological agents, clinical and biochemical features and prognosis are lacking. OBJECTIVE: To investigate the demographic data, clinical and biochemical characteristics, causative agents, treatment, and outcome of cases of DRESS in Hong Kong. METHODS: A single center retrospective study on 21 cases of DRESS from February 2007 to February 2011. Medical records, clinical photographs, and sequential laboratory data were reviewed. An attempt was made to identify any correlation among the clinical pattern and specific causative agents. MAIN OUTCOME MEASURES: Clinical and biochemical pattern for specific drugs, treatment outcome and prognosis of DRESS. RESULTS: Age of onset ranged from 14 to 77. No sex predilection was observed. The most common offending drug was allopurinol (28.6%), followed by phenobarbitone and trimethoprim-sulfamethoxazole. Mean latency period was 21.6 days. Exanthematous eruption was the most common cutaneous manifestation. Fever, hepatitis and eosinophilia were present in all cases. Renal impairment was observed in 7 patients (33.3%). Allopurinol-induced DRESS was associated with a higher frequency of preexisting renal insufficiency (P = .02) and increased risk of renal involvement as part of the syndrome (P = .002). Lichenoid dermatitis was the most common histopathologic feature. Systemic corticosteroid was commenced in 15 cases (71.4%). The average initial dose was 54.6 mg/day (0.95 mg/kg/day). The mean duration of corticosteroid use was 33 weeks. Steroid-sparing agents were used in 7 cases. Two cases in the case series developed autoimmune thyroiditis and one case developed bronchiolitis obliterans organizing pneumonia on subsequent follow-ups. The overall mortality was 4.8%. Prolonged erythroderma were observed in 2 cases induced by trimethoprim-sulfamethoxazole. CONCLUSION: DRESS is a form of severe cutaneous adverse reaction and associated with a variety of clinical and biochemical features. Allopurinol is a common causative agent of DRESS and its use in patients with pre-existing renal insufficiency should be cautiously monitored. Copyright © 2012 Published by Mosby, Inc.-
dc.languageengen_US
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/jaad-
dc.relation.ispartofJournal of American Academy of Dermatologyen_US
dc.subjectMedical sciences-
dc.subjectDermatology and venereology-
dc.titleDrug reaction with eosinophilia and systemic symptoms (DRESS): a retrospective analysis of 21 cases in a tertiary teaching hospital in Hong Kong.en_US
dc.typeConference_Paperen_US
dc.identifier.emailChan, JCY: chanjc@hku.hken_US
dc.identifier.emailYeung, CK: drcyeung@hku.hken_US
dc.identifier.authorityChan, JCY=rp01737en_US
dc.identifier.doi10.1016/j.jaad.2011.11.547-
dc.identifier.hkuros230814en_US
dc.identifier.volume66-
dc.identifier.issue4, suppl. 1-
dc.identifier.spageAB129, poster no. 5215-
dc.identifier.epageAB129, poster no. 5215-
dc.publisher.placeUnited States-

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