DRESS syndrome diagnostic criteria
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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 syndrome.
- Two diagnostic criteria have been proposed:
The following table illustrates the diagnostic criteria for the diagnosis of DRESS syndrome based on the RegiSCAR criteria and the Japanese consensus group criteria:
| 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
- ↑ 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.
- ↑ 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.