Summary We describe nine cases of anti-tuberculosis DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome, a potentially serious complication of treatment that led to interruption of treatment, systemic corticosteroid usage and the resumption of treatment with different regimens. All patients had skin rash, six out of nine patients with hepatitis, two out of nine patients had acute kidney injury, five out of nine patients died. All-cause mortality is high in our cohort.
Drug Hypersensitivity Syndrome

Humans ; Dapsone/adverse effects* ; Drug Hypersensitivity/etiology* ; Hypersensitivity ; Syndrome

Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) are severe cutaneous adverse reactions (SCAR) which are majorly caused by drugs. Though the incidence rate is low, SCAR sometimes can be life-threatening and leads to lifelong sequelae. Many pharmacogenomic associations in immune and nonimmune related genes with the development of SCAR have been discovered recently and the pharmacogenetic tests have been applied to prevent specific drug-induced SCAR. In this review, we discuss the recent advances of pharmacogenomics in SCAR.
Cicatrix ; Drug Hypersensitivity Syndrome ; Incidence ; Pharmacogenetics ; Stevens-Johnson Syndrome

There have been few cases of albumin hypersensitivity reported, and there is limited information on this condition. When a patient is anaphylactic to a certain drug and no alternative drug is available to treat the underlying condition, desensitization is a reasonable option and can be performed successfully to treat the patient. A standard 12-step, 3-solution rapid desensitization protocol allows the safe readministration of a medication after certain types of immediate hypersensitivity. However, we demonstrated that a new 10-step, 1-solution desensitization protocol using antihistamine and leukotriene receptor antagonist as premedications, which was effective and safe in a patient with hypersensitivity. We report a 13-year-old boy with Gorham-stout syndrome who was presented with newly acquired albumin anaphylaxis and successfully treated with the 10-step rapid drug desensitization protocol.
Adolescent ; Anaphylaxis ; Desensitization, Immunologic ; Drug Hypersensitivity Syndrome ; Humans ; Hypersensitivity* ; Hypersensitivity, Immediate ; Male ; Premedication ; Receptors, Leukotriene

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, also known as drug-induced hypersensitivity syndrome (DIHS), is a rare, acute and severe life-threatening systemic disease. DRESS syndrome is characterized by fever, lymphadenopathy, rash, hypereosinophilia and involvement of systemic organs. The most commonly implicated drugs are anticonvulsants, sulfonamides and allopurinol. Chloral hydrate is a sedative and hypnotic drug frequently used in pediatric patients. We first report a case of DRESS syndrome induced by chloral hydrate in a 14-month-old female.
Allopurinol ; Anticonvulsants ; Chloral Hydrate* ; Drug Hypersensitivity ; Drug Hypersensitivity Syndrome ; Eosinophilia* ; Exanthema* ; Female ; Fever ; Humans ; Hypersensitivity ; Infant ; Lymphatic Diseases ; Sulfonamides

No abstract available.
Drug Hypersensitivity Syndrome* ; Gastrointestinal Stromal Tumors* ; Imatinib Mesylate

Cytomegalovirus ; Cytomegalovirus Infections ; Drug Hypersensitivity Syndrome ; Eosinophilia ; Hepatitis ; Humans

Cytomegalovirus ; Cytomegalovirus Infections ; Drug Hypersensitivity Syndrome ; Eosinophilia ; Hepatitis ; Humans

Severe adverse cutaneous reactions (SCARs) include Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS). Although recent advances in pharmacogenomics have revealed the association between specific human leukocyte antigens (HLAs) and certain drug-induced SCARs, such associations were found in a limited number of drug-associated SCARs and are not sufficient to explain many other drug-related SCARs. After introducing research on the HLA-restricted T cell response, the role of the T cell receptor in drug binding was emphasized and a new concept called "pharmacological interactions of drug with immune receptors" has been conceptualized over recent decades. Currently, many international and domestic collaborative consortia have been formed and should enable the phenotypic standardization of SCARs at the earliest practicable time to provide valuable insights into its pathogenesis and to find an ideal method to prevent patients from developing SCARs.
Cicatrix ; Drug Hypersensitivity Syndrome ; HLA Antigens ; Humans ; Pharmacogenetics ; Receptors, Antigen, T-Cell ; Stevens-Johnson Syndrome

BACKGROUND/AIMS: Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) are severe cutaneous adverse reactions (SCARs) that also affect the internal organs with high mortality. However, there has been no previous nationwide study of SCARs in Korea. METHODS: Cases of SCARs were recruited from the nationwide Korean Pharmacovigilance Research Network database, collected from June 2009 to December 2010, by a spontaneous reporting system. We analyzed age, gender, route of administration and the causative agents. We also reviewed previously published cases of SCARs in Korea. RESULTS: In total, 100 cases of SJS (66 cases), TEN (7 cases), and DRESS (27 cases) were reported. The mean age of the patients was 54.1 +/- 19.8 years and the proportion of males to females was 1:0.88. In total, 81 drugs were reported as causative agents: SJS (61 drugs), TEN (15 drugs), and DRESS (29 drugs). The most commonly reported causative drug was allopurinol (12 cases). Allopurinol (8 cases) and levofloxacin (2 cases) were the most commonly reported causative drugs for SJS and TEN, respectively. In DRESS, allopurinol (4 cases) and vancomycin (4 cases) were the two most common causative drugs. Anti-infective drugs were the most common drug category (75 cases). Carbamazepine was the most commonly reported causative drug according to published cases in Korea. CONCLUSIONS: Allopurinol in the spontaneous reporting system and carbamazepine in the published cases were the most common single causative drugs in SCARs in Korea. Anti-infectives were the most common drug category in the spontaneous reporting system.
Allopurinol ; Carbamazepine ; Cicatrix ; Drug Hypersensitivity ; Drug Hypersensitivity Syndrome ; Drug-Related Side Effects and Adverse Reactions* ; Eosinophilia ; Female ; Humans ; Korea ; Levofloxacin ; Male ; Mortality ; Pharmacovigilance ; Stevens-Johnson Syndrome ; Vancomycin