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The symptoms of DRESS syndrome usually begin several weeks after exposure to the offending drug.  There is no gold standard for diagnosis, and at least two diagnostic criteria have been proposedThe RegiSCAR criteria <ref name=Kardaun>{{cite journal  |vauthors=Kardaun SH, Sidoroff A, Valeyrie-Allanore L, etal |title=Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms:  does a DRESS syndrome really exist? |journal=Response Br J Dermatol |volume=156 |pages=609–610 |year=2007 |pmid=17300272 |doi=10.1111/j.1365-2133.2006.07704.x |issue=3 }}</ref> and the Japanese consensus group criteria<ref name=Shiohara>{{cite journal |author=Shiohara T, Iijima M, Ikezawa Z, Hashimoto K. |title=The diagnosis of DRESS syndrome has been sufficiently established on the basis of typical clinical features and viral reactivations|journal=Response Br J Dermatol |volume=156 |pages=1045–92 |year=2007 |pmid=17381452 |issue=5 |doi=10.1111/j.1365-2133.2007.07807.x }}</ref> are detailed in the table below.   
__NOTOC__
{{DRESS syndrome}}
{{CMG}}; {{AE}}
 
==Overview==
==Diagnostic Criteria==
*There is no gold standard for the diagnosis of DRESS syndome.
*Two diagnostic criteria have been proposed:
:*The RegiSCAR criteria <ref name=Kardaun>{{cite journal  |vauthors=Kardaun SH, Sidoroff A, Valeyrie-Allanore L, etal |title=Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms:  does a DRESS syndrome really exist? |journal=Response Br J Dermatol |volume=156 |pages=609–610 |year=2007 |pmid=17300272 |doi=10.1111/j.1365-2133.2006.07704.x |issue=3 }}</ref>
:*The Japanese consensus group criteria<ref name=Shiohara>{{cite journal |author=Shiohara T, Iijima M, Ikezawa Z, Hashimoto K. |title=The diagnosis of DRESS syndrome has been sufficiently established on the basis of typical clinical features and viral reactivations|journal=Response Br J Dermatol |volume=156 |pages=1045–92 |year=2007 |pmid=17381452 |issue=5 |doi=10.1111/j.1365-2133.2007.07807.x }}</ref> are detailed in the table below.   
{| class="wikitable"
{| class="wikitable"
|-
|-
! RegiSCAR inclusion criteria for DRESS syndrome. Three of the four starred criteria required for diagnosis !! Japanese consensus group diagnostic criteria for DIHS.  Seven criteria needed for diagnosis of DIHS or the first five criteria required for diagnosis of atypical DIHS
! RegiSCAR inclusion criteria for DRESS syndrome. At least three of the four starred criteria are required for diagnosis !! Japanese consensus group diagnostic criteria for DIHS.  Seven criteria needed for the diagnosis of DRESS syndrome or the first five criteria required for diagnosis of atypical DIHS
|-
|-
| Hospitalization || Maculopapular rash developing > 3 weeks after starting the suspected drug
| Hospitalization || Maculopapular rash > 3 weeks following administration of drug
|-
|-
| Reaction suspected to be drug-related || Prolonged clinical symptoms 2 weeks after discontinuation of the suspected drug
| Reaction suspected to be drug-related || Prolonged clinical symptoms 2 weeks following the discontinuation of the suspected drug
|-
|-
| Acute Rash*|| Fever > 38&nbsp;°C
| Acute Rash*|| Fever > 38&nbsp;°C
|-
|-
| Fever > 38&nbsp;°C* || Liver abnormalities (ALT > 100 U/L) or other organ involvement
| Fever > 38&nbsp;°C* || Liver function test abnormalities (ALT > 100 U/L) or other organ involvement
|-
|-
| [[Lymphadenopathy]] in at least two sites* || [[Leukocyte]] abnormalities
| [[Lymphadenopathy]] in at least two sites* || [[Leukocyte]] abnormalities
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| || [[Human herpesvirus 6]] reactivation
| || [[Human herpesvirus 6]] reactivation
|}
|}
==References==
{{Reflist|2}}
[[Category:Syndromes]]
[[Category:Skin diseases]]
[[Category:Dermatology]]
[[Category:Hematology]]
[[Category:Hepatology]]
[[Category:Medicine]]

Revision as of 13:40, 21 September 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Diagnostic Criteria

  • There is no gold standard for the diagnosis of DRESS syndome.
  • Two diagnostic criteria have been proposed:
  • The RegiSCAR criteria [1]
  • The Japanese consensus group criteria[2] are detailed in the table below.
RegiSCAR inclusion criteria for DRESS syndrome. At least three of the four starred criteria are required for diagnosis Japanese consensus group diagnostic criteria for DIHS. Seven criteria needed for the diagnosis of DRESS syndrome or the first five criteria required for diagnosis of atypical DIHS
Hospitalization Maculopapular rash > 3 weeks following administration of drug
Reaction suspected to be drug-related Prolonged clinical symptoms 2 weeks following the discontinuation of the suspected drug
Acute Rash* Fever > 38 °C
Fever > 38 °C* Liver function test abnormalities (ALT > 100 U/L) or other organ involvement
Lymphadenopathy in at least two sites* Leukocyte abnormalities
Involvement of at least one internal organ* Leukocytosis ( > 11 x 109/L)
Blood count abnormalities (lymphopenia or lymphocytosis*, eosinophilia*, thrombocytopenia*) Atypical lymphocytosis (>5%)
Lymphadenopathy
Human herpesvirus 6 reactivation


References

  1. Kardaun SH, Sidoroff A, Valeyrie-Allanore L, et al. (2007). "Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist?". Response Br J Dermatol. 156 (3): 609–610. doi:10.1111/j.1365-2133.2006.07704.x. PMID 17300272.
  2. Shiohara T, Iijima M, Ikezawa Z, Hashimoto K. (2007). "The diagnosis of DRESS syndrome has been sufficiently established on the basis of typical clinical features and viral reactivations". Response Br J Dermatol. 156 (5): 1045–92. doi:10.1111/j.1365-2133.2007.07807.x. PMID 17381452.