Drug reaction with eosinophilia and systemic symptoms in pediatric patients: A clinicopathological study of 16 cases in the National Center of Pharmacovigilance of Tunisia.

Introduction: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe cutaneous adverse drug reaction (SCAR) that can affect the pediatric population. However, data on its characteristics in this age group are limited. This study aims to evaluate clinical and pathological features of cases of DRESS in children reported to the national center of pharmacovigilance of Tunisia.

Methods: We conducted a descriptive retrospective study on the cases of children with DRESS reported to the National Center of Pharmacovigilance of Tunisia between January 2011 and December 2017. We used for the diagnostic the criteria suggested by the European Registry of Severe Cutaneous Adverse Reactions (RegiSCAR).

Results: There were 16 patients with a diagnosis of DRESS. Mean age was six years. The most common offending drugs were anticonvulsants (68.75%). The mean latency period from using the culprit drug to the onset of drug reaction was 21 days. Skin lesions and internal organ involvement were present in all patients. Hepatitis was the most common visceral involvement. Eosinophilia (>1500 cells/μL) was present in 10 patients (62.5%). The outcome was favorable for all patients after drug withdrawal and symptomatic treatment.

Conclusion: Clinical features of DRESS in Tunisian children provide clinical information that could be useful for the early detection and the outcome improvement of this severe adverse reaction.