A Clinical Comparison of Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome in a Single Tertiary Hospital in Korea

Background: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare disease which can cause severe morbidity and mortality. We have reported DRESS syndrome was not more uncommon than generally recognized in the previous study.

Objective: We investigated the clinical manifestation of DRESS syndrome and compared with previous data.

Methods: A total of 100 patients were prospectively collected from October 2011 to March 2015 (period Ⅰ, 43 months). We compared these data to those of 42 DRESS patients from September 2009 to August 2011 (period II, 24 months).

Results: The most common causative drugs were antibiotics, followed by anticonvulsants  and antituberculosis drugs in both periods (37%, 17%, 17% in period Ⅰ vs 31%, 24%, 13% in period II, respectively). Eosinophilia in peripheral blood and hepatic involvement was more frequently noted in period II, while enlarged lymph nodes in period Ⅰ significantly. The mean latency period was 32.6±107.5 days (range, 1-1095) in period Ⅰ, and 20.2±24.3days (range, 2-120) in period II (P=0.255). The longest latency period was noted for the antituberculosis drugs, followed by anticonvulsants and antibiotics in both periods. Systemic corticosteroids were administered to 22 patients (20%) and 10 (22%) in each period. All the patients showed complete recovery in period ±, while 2 patients (4.4%) had poor outcomes.

Conclusions: The clinical manifestation of DRESS syndrome was variable. Antibiotics were the most frequently implicated drugs and antituberculosis drugs had a long latency period. A majority of patients showed good clinical outcomes without administration of systemic corticosteroid.

Acknowledgement

This research was supported by a grant from Ministry of Food and Drug Safety to operation of the regional pharmacovigilance center in 2015.