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St George-Hyslop F, Cherepacha N, Chugani B, Alabdeen Y, Sanchez-Espino LF, Mahood Q, Sibbald C, Verstegen RHJ. Drug-specific presentation and outcome of drug reaction with eosinophilia and systemic symptoms (DRESS) in children: a scoping review. Clin Exp Dermatol 2025; 50:408-411. [PMID: 39392933 DOI: 10.1093/ced/llae418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 09/19/2024] [Accepted: 09/27/2024] [Indexed: 10/13/2024]
Abstract
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe adverse drug reaction with significant variation between patients concerning presenting symptoms and disease severity. Under the hypothesis that the clinical presentation of DRESS is drug specific, we performed a scoping review and identified 644 cases of paediatric DRESS. A single implicated drug was present in 262 cases, and drugs with 10 or more cases were included in this analysis (n = 224): carbamazepine (n = 86), dapsone (n = 16), lamotrigine (n = 25), phenobarbital (n = 38), phenytoin (n = 45) and trimethoprim-sulfamethoxazole (n = 14). Dapsone was associated with increased organ involvement, the highest mortality rate and the longest period of hospitalization. In addition, we showed that trimethoprim-sulfamethoxazole was associated with higher rates of autoimmune sequelae. This study confirms that drug-specific features exist and may impact the acute and long-term management of DRESS in children.
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Affiliation(s)
- Frances St George-Hyslop
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Clinical Pharmacology & Toxicology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Nicole Cherepacha
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Clinical Pharmacology & Toxicology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Bindiya Chugani
- Division of Clinical Pharmacology & Toxicology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Yousef Alabdeen
- Division of Immunology and Allergy, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Luis Fernando Sanchez-Espino
- Division of Dermatology, Department of Paediatrics, Stollery Children's Hospital, Edmonton, AB, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Quenby Mahood
- Hospital Library, The Hospital for Sick Children, Toronto, ON, Canada
| | - Cathryn Sibbald
- Division of Dermatology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Ruud H J Verstegen
- Division of Clinical Pharmacology & Toxicology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
- Division of Rheumatology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
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