DRESS syndrome other diagnostic studies: Difference between revisions
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{{DRESS syndrome}} | {{DRESS syndrome}} | ||
{{CMG}}; {{AE}} {{YD}}; {{SSK}} | {{CMG}}; {{AE}} {{YD}}; {{SSK}} | ||
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==Overview== | ==Overview== | ||
Other diagnostic studies for DRESS syndrome include elevated anti-HHV-6 IgG antibody, positive lymphocyte activation test, patch testing, and rechallenging of the suspected drug. | Other diagnostic studies for DRESS syndrome include elevated anti-HHV-6 IgG antibody, positive lymphocyte activation test, patch testing, and rechallenging of the suspected drug. | ||
==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
===Anti-HHV-6 Antibody=== | ===Anti-HHV-6 Antibody=== | ||
*Herpes virus reactivation is common among patients with DRESS syndrome and may occur in approximately 80% of cases.<ref name="pmid21592453">{{cite journal| author=Cacoub P, Musette P, Descamps V, Meyer O, Speirs C, Finzi L et al.| title=The DRESS syndrome: a literature review. | journal=Am J Med | year= 2011 | volume= 124 | issue= 7 | pages= 588-97 | pmid=21592453 | doi=10.1016/j.amjmed.2011.01.017 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21592453 }} </ref> | *Herpes virus reactivation is common among patients with DRESS syndrome and may occur in approximately 80% of cases.<ref name="pmid21592453">{{cite journal| author=Cacoub P, Musette P, Descamps V, Meyer O, Speirs C, Finzi L et al.| title=The DRESS syndrome: a literature review. | journal=Am J Med | year= 2011 | volume= 124 | issue= 7 | pages= 588-97 | pmid=21592453 | doi=10.1016/j.amjmed.2011.01.017 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21592453 }} </ref> | ||
*Elevated anti-HHV-6 IgG antibody is thought to be a useful diagnostic test when DRESS syndrome is suspected.<ref name="pmid21592453">{{cite journal| author=Cacoub P, Musette P, Descamps V, Meyer O, Speirs C, Finzi L et al.| title=The DRESS syndrome: a literature review. | journal=Am J Med | year= 2011 | volume= 124 | issue= 7 | pages= 588-97 | pmid=21592453 | doi=10.1016/j.amjmed.2011.01.017 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21592453 }} </ref> | *Elevated anti-HHV-6 IgG antibody is thought to be a useful diagnostic test when DRESS syndrome is suspected.<ref name="pmid21592453">{{cite journal| author=Cacoub P, Musette P, Descamps V, Meyer O, Speirs C, Finzi L et al.| title=The DRESS syndrome: a literature review. | journal=Am J Med | year= 2011 | volume= 124 | issue= 7 | pages= 588-97 | pmid=21592453 | doi=10.1016/j.amjmed.2011.01.017 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21592453 }} </ref> | ||
===Skin Biopsy=== | ===Skin Biopsy=== | ||
*Skin biopsy may be helpful in the diagnosis, but there is no characteristic finding on skin biopsy that is associated with DRESS syndrome. To view all possible findings on skin biopsy, click [[DRESS syndrome pathophysiology#pathology|'''here''']]. | *Skin biopsy may be helpful in the diagnosis, but there is no characteristic finding on skin biopsy that is associated with DRESS syndrome. To view all possible findings on skin biopsy, click [[DRESS syndrome pathophysiology#pathology|'''here''']]. | ||
===Lymphocyte Activation Test=== | ===Lymphocyte Activation Test=== | ||
*The lymphocyte activation test is characterized by a low sensitivity and low specificity for DRESS syndrome.<ref name="pmid17983378">{{cite journal| author=Kano Y, Hirahara K, Mitsuyama Y, Takahashi R, Shiohara T| title=Utility of the lymphocyte transformation test in the diagnosis of drug sensitivity: dependence on its timing and the type of drug eruption. | journal=Allergy | year= 2007 | volume= 62 | issue= 12 | pages= 1439-44 | pmid=17983378 | doi=10.1111/j.1398-9995.2007.01553.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17983378 }} </ref> | *The lymphocyte activation test is characterized by a low sensitivity and low specificity for DRESS syndrome.<ref name="pmid17983378">{{cite journal| author=Kano Y, Hirahara K, Mitsuyama Y, Takahashi R, Shiohara T| title=Utility of the lymphocyte transformation test in the diagnosis of drug sensitivity: dependence on its timing and the type of drug eruption. | journal=Allergy | year= 2007 | volume= 62 | issue= 12 | pages= 1439-44 | pmid=17983378 | doi=10.1111/j.1398-9995.2007.01553.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17983378 }} </ref> | ||
*The test may be falsely negative during the acute phase of DRESS syndrome.<ref name="pmid17983378">{{cite journal| author=Kano Y, Hirahara K, Mitsuyama Y, Takahashi R, Shiohara T| title=Utility of the lymphocyte transformation test in the diagnosis of drug sensitivity: dependence on its timing and the type of drug eruption. | journal=Allergy | year= 2007 | volume= 62 | issue= 12 | pages= 1439-44 | pmid=17983378 | doi=10.1111/j.1398-9995.2007.01553.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17983378 }} </ref> | *The test may be falsely negative during the acute phase of DRESS syndrome.<ref name="pmid17983378">{{cite journal| author=Kano Y, Hirahara K, Mitsuyama Y, Takahashi R, Shiohara T| title=Utility of the lymphocyte transformation test in the diagnosis of drug sensitivity: dependence on its timing and the type of drug eruption. | journal=Allergy | year= 2007 | volume= 62 | issue= 12 | pages= 1439-44 | pmid=17983378 | doi=10.1111/j.1398-9995.2007.01553.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17983378 }} </ref> | ||
===Patch Testing=== | ===Patch Testing=== | ||
*The diagnostic efficacy of patch testing is still controversial. | *The diagnostic efficacy of patch testing is still controversial. | ||
*Patch testing has yielded variable results and is presumed to be effective only when the suspected triggering agent is an anticonvulsant.<ref name="pmid20136879">{{cite journal| author=Santiago F, Gonçalo M, Vieira R, Coelho S, Figueiredo A| title=Epicutaneous patch testing in drug hypersensitivity syndrome (DRESS). | journal=Contact Dermatitis | year= 2010 | volume= 62 | issue= 1 | pages= 47-53 | pmid=20136879 | doi=10.1111/j.1600-0536.2009.01659.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20136879 }} </ref> The efficacy of patch testing requires further validation. | *Patch testing has yielded variable results and is presumed to be effective only when the suspected triggering agent is an anticonvulsant.<ref name="pmid20136879">{{cite journal| author=Santiago F, Gonçalo M, Vieira R, Coelho S, Figueiredo A| title=Epicutaneous patch testing in drug hypersensitivity syndrome (DRESS). | journal=Contact Dermatitis | year= 2010 | volume= 62 | issue= 1 | pages= 47-53 | pmid=20136879 | doi=10.1111/j.1600-0536.2009.01659.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20136879 }} </ref> The efficacy of patch testing requires further validation. | ||
===Rechallenge Suspected Drug=== | ===Rechallenge Suspected Drug=== | ||
*The approach has been used in other drug eruptions, but it has not been validated as a diagnostic strategy for DRESS syndrome given the potential life-threatening complications of the disease.<ref name="pmid23882307">{{cite journal| author=Choudhary S, McLeod M, Torchia D, Romanelli P| title=Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome. | journal=J Clin Aesthet Dermatol | year= 2013 | volume= 6 | issue= 6 | pages= 31-7 | pmid=23882307 | doi= | pmc=PMC3718748 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23882307 }} </ref> | *The approach has been used in other drug eruptions, but it has not been validated as a diagnostic strategy for DRESS syndrome given the potential life-threatening complications of the disease.<ref name="pmid23882307">{{cite journal| author=Choudhary S, McLeod M, Torchia D, Romanelli P| title=Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome. | journal=J Clin Aesthet Dermatol | year= 2013 | volume= 6 | issue= 6 | pages= 31-7 | pmid=23882307 | doi= | pmc=PMC3718748 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23882307 }} </ref> | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
[[Category:Hematology]] | [[Category:Hematology]] | ||
[[Category:Hepatology]] | [[Category:Hepatology]] | ||
{{WS}} | |||
{{WH}} | |||
Revision as of 12:22, 20 July 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Serge Korjian M.D.
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Overview
Other diagnostic studies for DRESS syndrome include elevated anti-HHV-6 IgG antibody, positive lymphocyte activation test, patch testing, and rechallenging of the suspected drug.
Other Diagnostic Studies
Anti-HHV-6 Antibody
- Herpes virus reactivation is common among patients with DRESS syndrome and may occur in approximately 80% of cases.[1]
- Elevated anti-HHV-6 IgG antibody is thought to be a useful diagnostic test when DRESS syndrome is suspected.[1]
Skin Biopsy
- Skin biopsy may be helpful in the diagnosis, but there is no characteristic finding on skin biopsy that is associated with DRESS syndrome. To view all possible findings on skin biopsy, click here.
Lymphocyte Activation Test
- The lymphocyte activation test is characterized by a low sensitivity and low specificity for DRESS syndrome.[2]
- The test may be falsely negative during the acute phase of DRESS syndrome.[2]
Patch Testing
- The diagnostic efficacy of patch testing is still controversial.
- Patch testing has yielded variable results and is presumed to be effective only when the suspected triggering agent is an anticonvulsant.[3] The efficacy of patch testing requires further validation.
Rechallenge Suspected Drug
- The approach has been used in other drug eruptions, but it has not been validated as a diagnostic strategy for DRESS syndrome given the potential life-threatening complications of the disease.[4]
References
- ↑ 1.0 1.1 Cacoub P, Musette P, Descamps V, Meyer O, Speirs C, Finzi L; et al. (2011). "The DRESS syndrome: a literature review". Am J Med. 124 (7): 588–97. doi:10.1016/j.amjmed.2011.01.017. PMID 21592453.
- ↑ 2.0 2.1 Kano Y, Hirahara K, Mitsuyama Y, Takahashi R, Shiohara T (2007). "Utility of the lymphocyte transformation test in the diagnosis of drug sensitivity: dependence on its timing and the type of drug eruption". Allergy. 62 (12): 1439–44. doi:10.1111/j.1398-9995.2007.01553.x. PMID 17983378.
- ↑ Santiago F, Gonçalo M, Vieira R, Coelho S, Figueiredo A (2010). "Epicutaneous patch testing in drug hypersensitivity syndrome (DRESS)". Contact Dermatitis. 62 (1): 47–53. doi:10.1111/j.1600-0536.2009.01659.x. PMID 20136879.
- ↑ Choudhary S, McLeod M, Torchia D, Romanelli P (2013). "Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome". J Clin Aesthet Dermatol. 6 (6): 31–7. PMC 3718748. PMID 23882307.