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de Groot AC. Patch testing in Drug reaction with eosinophilia and systemic symptoms (DRESS): a literature review. Contact Dermatitis 2022; 86:443-479. [PMID: 35233782 DOI: 10.1111/cod.14090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/15/2022] [Accepted: 02/24/2022] [Indexed: 11/27/2022]
Abstract
The literature on positive patch test results in drug reaction with eosinophilia and systemic symptoms (DRESS) is reviewed. 105 drugs were identified that have together caused 536 positive patch tests in 437 patients suffering from DRESS. By far most reactions (n=145) were caused by carbamazepine, followed by amoxicillin, isoniazid, phenytoin, ethambutol, fluindione, phenobarbital, rifampicin, and ceftriaxone; 43 drugs each caused a single case only. The drug classes causing the highest number of reactions are anticonvulsants (39%), beta-lactam antibiotics (20%), antituberculosis agents (11%), non-beta-lactam antibiotics (6%) and iodinated contrast media (5%). The sensitivity of patch testing (percentage of positive reactions) is high for anticonvulsants (notably carbamazepine), beta-lactam antibiotics (notably amoxicillin) and possibly iodinated contrast media. Allopurinol and sulfasalazine frequently cause DRESS, but never give positive patch tests. Patch testing in DRESS appears to be safe, although mild recurrence of DRESS symptoms, mostly skin reactions, may not be rare. Multiple drug hypersensitivity was found to occur in 16% of all patients, but it is argued that the true frequency is (far) higher. Clinical aspects of DRESS, including diagnosing the disease and identifying culprit drugs (patch tests, intradermal tests, in vitro tests, challenge tests) are also provided, emphasizing the role of patch testing. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Anton C de Groot
- dermatologist np Schipslootweg 5, 8351, HV, Wapserveen, The Netherlands
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Jin HJ, Kang DY, Nam YH, Ye YM, Koh YI, Hur GY, Kim SH, Yang MS, Kim S, Jeong YY, Kim MH, Choi JH, Kang HR, Jo EJ, Park HK. Severe Cutaneous Adverse Reactions to Anti-tuberculosis Drugs in Korean Patients. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2021; 13:245-255. [PMID: 33474859 PMCID: PMC7840880 DOI: 10.4168/aair.2021.13.2.245] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 07/08/2020] [Accepted: 07/30/2020] [Indexed: 12/18/2022]
Abstract
Purpose Anti-tuberculosis drugs (ATDs) can cause severe cutaneous adverse reactions (SCARs) such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS). Underlying tuberculous infection and co-administration of multiple drugs may contribute to the complexity of ATD-related SCARs. This study aimed to investigate the clinical characteristics and outcomes of ATD-related SCARs. Methods We analyzed ATD-related SCAR cases in 2010-2015, selected from a web-based Database of the Korean Registry of SCAR. Results Among 783, 53 patients with ATD-induced SCARs were enrolled, including 12 with SJS/TEN (22.6%) and 41 with DRESS (77.4%). When comparing the ATD and non-ATD groups, the prevalence of DRESS patients was higher in the ATD group than in the non-ATD group (77.4% vs. 45.8%, P < 0.001). Among patients with ATD-related SCARs, those with SJS/TEN were significantly older, had higher intensive care unit admissions, and had higher mortality than those with DRESS (70.5 vs. 50.0 years, P < 0.001; 41.7% vs. 6.1%, P = 0.010; and 33.3% vs. 2.5%, P = 0.003, respectively). ATDs were challenged in 14 cases. The ATD associated most often with SCAR cases was rifampin (81.8%), followed by isoniazid (66.7%), ethambutol (50.0%), pyrazinamide (33.3%). Six patients (42.9%) had hypersensitivity reactions to 2 or more drugs. Conclusions DRESS was more common among the ATD-related SCAR cases. Although treatment with most ATDs carries the risk of SCAR development, the use of rifampin was most frequently involved in the occurrence of SCARs. Multiple hypersensitivity was frequently observed in ATD-related SCARs.
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Affiliation(s)
- Hyun Jung Jin
- Department of Internal Medicine, Medical School of Yeungnam University, Daegu, Korea
| | - Dong Yoon Kang
- Drug Safety Monitoring Center, Seoul National University Hospital, Seoul, Korea
| | - Young Hee Nam
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea
| | - Young Min Ye
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Young Il Koh
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Gyu Young Hur
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sae Hoon Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min Suk Yang
- Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Sujeong Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Yi Yeong Jeong
- Department of Internal Medicine, Gyeongsang National University College of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Min Hye Kim
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Jeong Hee Choi
- Department of Pulmonology and Allergy, Hallym University Dongtan Sacred Heart Hospital, Hwaseong and Allergy and Clinical Immunology Research Center, Hallym University College of Medicine, Chuncheon, Korea
| | - Hye Ryun Kang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Jung Jo
- Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea
| | - Hye Kyung Park
- Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea.
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Lefebvre M, Walencik A, Allavena C, Billaud E, Kassi A, Cesbron A, Joyau C, Secher S, Ruellan AL, Raffi F. Rate of DRESS Syndrome With Raltegravir and Role of the HLA-B*53: 01 Allele. J Acquir Immune Defic Syndr 2020; 85:e77-e80. [PMID: 33136758 DOI: 10.1097/qai.0000000000002474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Maeva Lefebvre
- Infectious Diseases Department, CHU Hôtel Dieu and INSERM UIC 1413 Nantes University, Nantes, France
| | - Alexandre Walencik
- HLA laboratory, Etablissement Français du Sang Centre-Pays de la Loire, Nantes, France
| | - Clotilde Allavena
- Infectious Diseases Department, CHU Hôtel Dieu and INSERM UIC 1413 Nantes University, Nantes, France
| | - Eric Billaud
- Infectious Diseases Department, CHU Hôtel Dieu and INSERM UIC 1413 Nantes University, Nantes, France
| | - Alain Kassi
- Infectious Diseases Department, CHU Hôtel Dieu and INSERM UIC 1413 Nantes University, Nantes, France
- Infectious Diseases Department, CHU de Treichville, BP V 3, Abidjan, Côte d'Ivoire; and
| | - Anne Cesbron
- HLA laboratory, Etablissement Français du Sang Centre-Pays de la Loire, Nantes, France
| | - Caroline Joyau
- Clinical Pharmacology Department, Biology Institute, CHU Hôtel Dieu, Nantes, France
| | - Solène Secher
- Infectious Diseases Department, CHU Hôtel Dieu and INSERM UIC 1413 Nantes University, Nantes, France
| | - Anne-Lise Ruellan
- Clinical Pharmacology Department, Biology Institute, CHU Hôtel Dieu, Nantes, France
| | - François Raffi
- Infectious Diseases Department, CHU Hôtel Dieu and INSERM UIC 1413 Nantes University, Nantes, France
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Prakash Babu S, Narasimhan PB, Babu S. Eosinophil Polymorphonuclear Leukocytes in TB: What We Know so Far. Front Immunol 2019; 10:2639. [PMID: 31798582 PMCID: PMC6868031 DOI: 10.3389/fimmu.2019.02639] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/24/2019] [Indexed: 01/21/2023] Open
Abstract
Knowledge on the cellular immune responses to infection with Mycobacterium tuberculosis has improved drastically in recent years. Though eosinophils and hypereosinophilia are linked with the disease process of tuberculosis, there is paucity of information to prove the actual role played by these polymorphonuclear leukocytes. The aim of this review is to provide an overview of the existing literature on what is known so far about eosinophils and tuberculosis.
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Affiliation(s)
| | - Prakash B Narasimhan
- Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Subash Babu
- National Institute of Research in Tuberculosis (ICMR), Chennai, India.,Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases (NIH), Bethesda, MD, United States
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Kapur A, Rehan HS. Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome Associated with Ethambutol use: A Case Report. Curr Drug Saf 2019; 14:249-251. [PMID: 30848209 PMCID: PMC6864591 DOI: 10.2174/1574886314666190307150757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 02/25/2019] [Accepted: 02/28/2019] [Indexed: 12/18/2022]
Abstract
Background:
Among the first line Anti-Tubercular Drugs (ATDs), ethambutol has been
rarely associated to cause drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome.
Case Report:
A 34-year-old woman presented in an out-patient department of Dermatology with fever,
skin eruptions, eosino- philia, hyperinflated lung fields and deranged liver enzymes after 35 days of the
initiation of ATDs. The patient recovered completely after stopping ethambutol and administration of
topical and sys- temic corticosteroids.
Results and Conclusion:
Based on the available evidences of de-challenge and re-challenge of suspected
drugs, ethambutol was certainly implicated to cause DRESS syndrome.
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Affiliation(s)
- Ajita Kapur
- Department of Pharmacology, Lady Hardinge Medical College and Associated Hospitals, New Delhi 110001, India
| | - Harmeet Singh Rehan
- Department of Pharmacology, Lady Hardinge Medical College and Associated Hospitals, New Delhi 110001, India
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Ingen-Housz-Oro S, Assier H, Gener G, Milpied B, Soria A, Bernier C, Descamps V, Tetart F, Staumont-Sallé D, Valeyrie-Allanore L, Valois A, Sassolas B, Bensaid B, Lebrun-Vignes B, Barbaud A. [Delayed hypersensitivity to anti-tuberculosis drugs. Proposed practical management plan for exanthema: when to stop, which allergological investigations to perform, and how to restart treatment]. Ann Dermatol Venereol 2019; 146:313-318. [PMID: 30904277 DOI: 10.1016/j.annder.2019.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 10/06/2018] [Accepted: 01/15/2019] [Indexed: 12/20/2022]
Affiliation(s)
- S Ingen-Housz-Oro
- Service de dermatologie, hôpital Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France; Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France.
| | - H Assier
- Service de dermatologie, hôpital Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France; Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France
| | - G Gener
- Service de dermatologie, hôpital Henri-Mondor, AP-HP, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France; Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France
| | - B Milpied
- Service de dermatologie, hôpital Saint-André, 1, rue Jean-Burguet, 33000 Bordeaux, France; Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France
| | - A Soria
- Service de dermatologie et allergologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France
| | - C Bernier
- Service de dermatologie, CHU Hôtel-Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France; Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France
| | - V Descamps
- Service de dermatologie, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France; Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France
| | - F Tetart
- Service de dermatologie, CHU Charles-Nicolle, 1, rue De Germont, 76100 Rouen, France; Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France
| | - D Staumont-Sallé
- Service de dermatologie, CHRU Claude-Huriez, rue Michel-Polonovski, 59000 Lille, France; Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France
| | - L Valeyrie-Allanore
- Cabinet de dermatologie, 18, avenue Quihou, 94160 Saint-Mandé, France; Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France
| | - A Valois
- Service de dermatologie, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83800 Toulon cedex 9, France; Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France
| | - B Sassolas
- Service de médecine interne, hôpital Cavale-Blanche, CHRU de Brest, boulevard Tanguy Prigent, 29600 Brest, France; Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France
| | - B Bensaid
- Service de dermatologie, hôpital Edouard-Herriot, 5, place D'Arsonval, 69003 Lyon, France; Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France
| | - B Lebrun-Vignes
- Département de pharmacovigilance, hôpital La Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France
| | - A Barbaud
- Service de dermatologie et allergologie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France
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- Groupe FISARD (groupe Toxidermies) de la Société française de dermatologie, 10, cité Malesherbes, 75009 Paris, France
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