DRESS syndrome diagnostic criteria
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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
There is no gold standard for the diagnosis of DRESS syndrome. Two diagnostic criteria have been proposed: The RegiSCAR criteria and the Japanese Consensus Group criteria.
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 DRESS/DIHS syndrome A total of Seven criteria needed for the diagnosis of typical DRESS/DIHS syndrome / the first five criteria are required for the diagnosis of atypical DRESS/DIHS syndrome |
|---|---|
| Acute Rash* | Maculopapular rash > 3 weeks following administration of drug |
| Fever > 38 °C* | Prolonged clinical symptoms 2 weeks following the discontinuation of the suspected drug |
| Lymphadenopathy in at least two sites* | Fever > 38 °C |
| Involvement of at least one internal organ* | Liver function test abnormalities (ALT > 100 U/L) or other organ involvement |
| Hospitalization | Leukocyte abnormalities |
| Reaction suspected to be drug-related | 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.