DRESS syndrome natural history, complications and prognosis: Difference between revisions
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==Natural History== | ==Natural History== | ||
*DRESS syndrome is characterized by a prolonged latency period. | *DRESS syndrome is characterized by a prolonged latency period. | ||
*Clinical manifestations of DRESS syndrome are usually delayed 2-8 weeks following the administration of triggering drug. | *Clinical manifestations of DRESS syndrome are usually delayed. Earliest manifestations may appear 2-8 weeks following the administration of triggering drug. | ||
*Initially, patients usually develop non-specific signs and symptoms, namely fever and rash. | *Initially, patients usually develop non-specific signs and symptoms, namely fever and rash, making the early diagnosis of DRESS syndrome difficult upon patient presentation. | ||
*Additional clinical manifestations follow, and patients may subsequently develop lymphadenopathy, visceral disease, and worsening of the skin eruption. | *Additional clinical manifestations follow, and patients may subsequently develop lymphadenopathy, visceral disease (typically liver involvement), and worsening of the skin eruption. | ||
*The nature of the visceral involvement is thought to be associated with the identity of the triggering drug. | |||
:*Hepatic and GI involvement has been associated with abacavir | |||
:*Renal involvement has been associated with allopurinol | |||
:*Pulmonary involvement has been associated with abacavir and minocycline | |||
*In the majority of cases, DRESS syndrome resolves following the discontinuation of triggering drug, but clinical manifestations may persist up to 3 months. | *In the majority of cases, DRESS syndrome resolves following the discontinuation of triggering drug, but clinical manifestations may persist up to 3 months. | ||
| Line 14: | Line 18: | ||
*Organ involvement is considered the most important complication of DRESS syndrome. | *Organ involvement is considered the most important complication of DRESS syndrome. | ||
*Complications of DRESS syndrome include the following: | *Complications of DRESS syndrome include the following: | ||
:*[[Hepatitis]] | :*[[Hepatitis]] and [[hepatic necrosis]] | ||
:*[[Interstitial nephritis]] | :*[[Interstitial nephritis]] | ||
:*[[Pneumonitis]] | :*[[Pneumonitis]] | ||
Revision as of 15:53, 21 September 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Natural History
- DRESS syndrome is characterized by a prolonged latency period.
- Clinical manifestations of DRESS syndrome are usually delayed. Earliest manifestations may appear 2-8 weeks following the administration of triggering drug.
- Initially, patients usually develop non-specific signs and symptoms, namely fever and rash, making the early diagnosis of DRESS syndrome difficult upon patient presentation.
- Additional clinical manifestations follow, and patients may subsequently develop lymphadenopathy, visceral disease (typically liver involvement), and worsening of the skin eruption.
- The nature of the visceral involvement is thought to be associated with the identity of the triggering drug.
- Hepatic and GI involvement has been associated with abacavir
- Renal involvement has been associated with allopurinol
- Pulmonary involvement has been associated with abacavir and minocycline
- In the majority of cases, DRESS syndrome resolves following the discontinuation of triggering drug, but clinical manifestations may persist up to 3 months.
Complications
- Organ involvement is considered the most important complication of DRESS syndrome.
- Complications of DRESS syndrome include the following:
Prognosis
- The prognosis of DRESS syndrome is generally good.
- The case-fatality rate of DRESS syndrome is approximately 10%.