Clinical features of drug-induced hypersensitivity syndrome in 38 patients

Background: the clinical features of drug-induced hypersensitivity syndrome (dihs) or drug rash with eosinophilia and systemic symptoms (dress) syndrome are complicated,and the incidence of this condition is very low. objective: to evaluate the clinical course of dihs/dress and identify effective treatment options. methods: this study was a retrospective analysis of prospectively collected clinical data in 38 consecutive patients with dihs/dress diagnosed between march 2004 and january 2009. we investigated the clinical features,response to treatment,and outcome of 38 patients. results: the study patients consisted of 18 men (47.4%) and 20 women (52.6%). the most common causative drugs were anticonvulsants (47.4%) and antibiotics (18.4%),followed by nonsteroidal anti-inflammatory drugs (nsaids) (13.2%),allopurinol (5.3%),and undetermined agents (15.8%). the latency period ranged from 3 to 105 days,with a mean (sd) of 25.2 (21.5) days. systemic corticosteroids were administered to 16 patients (42.1%). twenty-two (57.9%) patients were treated with topical corticosteroids and antihistamines (no systemic corticosteroids). complete recovery was noted in 36 patients (94.8%). two of the patients treated with systemic corticosteroids had a poor outcome: one died due to an opportunistic infection secondary to long-term systemic corticosteroid treatment; the other showed progressive deterioration of liver damage,although the fi nal outcome is not known. conclusion: the drugs associated with dihs/dress were variable and most frequently included anticonvulsants,ß-lactam antibiotics,and nsaids. the syndrome was more common than generally recognized. additional studies are needed to evaluate the clinical indications for systemic corticosteroids in patients with dihs/dress. © 2010 esmon publicidad.