The syndrome termed 'Drug Reaction with Eosinophilia and Systemic Symptoms' (DRESS) is an unpredictable, life-threatening condition associated with adverse reactions to therapy. Although the etiology of DRESS is poorly understood, genetic susceptibility markers have been identified within the HLA complex and there are several prevailing models of pathogenesis. Modification of host antigens by haptens (drugs or their metabolites), or non-covalent drug binding to endogenous proteins (the p-i concept), may drive pro-inflammatory immune responses in patients. Alternatively, a viral trigger for DRESS has been proposed based on the concomitant detection of herpesviruses and the recent demonstration of Epstein-Barr virus-specific immune responses in DRESS patients. In the present review, we discuss the latest findings concerning the pathogenesis of drug reactions and known risk factors for DRESS.
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http://dx.doi.org/10.1016/j.coi.2012.07.010 | DOI Listing |
BMJ Case Rep
January 2025
Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome and haemophagocytic lymphohistiocytosis (HLH) are rare but severe immune-mediated diseases with overlapping clinical manifestations. We present a case of a woman in her late 40s with rheumatoid arthritis who developed DRESS/HLH overlap syndrome after starting hydroxychloroquine and leflunomide therapy. Despite corticosteroid treatment, her condition worsened, necessitating etoposide therapy.
View Article and Find Full Text PDFCurr Allergy Asthma Rep
January 2025
Rochester Regional Health, Rochester, NY, USA.
Background: Antiepileptics are the mainstay of treatment for seizure management. Immediate and delayed hypersensitivity reactions associated with antiepileptics are common. It is important to differentiate between these reactions as management and prognosis varies.
View Article and Find Full Text PDFIntroduction: Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a severe hypersensitivity reaction rarely documented in patients with multiple myeloma (MM).
Methods: In our retrospective study of 108 newly diagnosed MM (NDMM) patients from January 2021 to October 2023, we identified four cases of DRESS. The clinical characteristics such as clinical manifestations, laboratory results, treatment and outcome were analyzed.
Ther Adv Drug Saf
January 2025
Unidad Especializada en Tuberculosis, Servicio de Neumologia, Hospital Nacional Dos de Mayo, Lima, Perú.
The overlap of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) and Stevens-Johnson syndrome (SJS) caused by antituberculosis drugs represents an extremely rare event. This situation can manifest between 2 and 8 weeks after the first exposure to the medication. The overlap of these conditions can lead to atypical clinical manifestations, thus complicating the early diagnosis and the implementation of early treatment.
View Article and Find Full Text PDFJ Am Acad Dermatol
January 2025
Weill Cornell Medicine, Department of Dermatology, New York, NY. Electronic address:
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