Ganeva Maria, Gancheva Tanya, Lazarova Roumiana, Troeva Jeni, Baldaranov Ivan, Vassilev Ivan, Hristakieva Evgenya, Tzaneva Valentina
Section of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Thracian University, Stara Zagora, Bulgaria.
Int J Dermatol. 2008 Aug;47(8):853-60. doi: 10.1111/j.1365-4632.2008.03637.x.
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but severe drug reaction, most commonly to aromatic anticonvulsants with a delayed onset, variable clinical presentation and protracted course. The exact incidence of DRESS syndrome is not known because of the variability in clinical presentation, lack of strict diagnostic criteria and universally accepted nomenclature. We report four cases of DRESS syndrome associated with the use of carbamazepine. The clinical manifestation was similar: a maculopapular eruption progressing to exfoliative erythroderma, fever, and lymphadenopathy. Leukocytosis, atypical lymphocytes and liver injury (in 2 patients) were also observed. Assessment of causality using the Naranjo algorithm established a "probable" relationship with carbamazepine in three of the cases and a "possible" relationship in one case. Detection of DRESS syndrome is dependent on the exclusion of a variety of diseases with similar manifestations and may be delayed in time. DRESS syndrome is a potentially life-threatening multisystem adverse drug reaction, and accidental reexposure or drug provocation tests must be avoided.
药物超敏反应伴嗜酸性粒细胞增多和全身症状（DRESS）综合征是一种罕见但严重的药物反应，最常见于芳香族抗惊厥药，起病延迟，临床表现多样，病程迁延。由于临床表现的变异性、缺乏严格的诊断标准和普遍接受的命名法，DRESS综合征的确切发病率尚不清楚。我们报告4例与使用卡马西平相关的DRESS综合征。临床表现相似：斑丘疹进展为剥脱性红皮病、发热和淋巴结病。还观察到白细胞增多、非典型淋巴细胞和肝损伤（2例患者）。使用Naranjo算法评估因果关系，3例病例与卡马西平建立了“可能”的关系，1例病例建立了“可能”的关系。DRESS综合征的诊断依赖于排除各种具有相似表现的疾病，且可能会延迟。DRESS综合征是一种潜在的危及生命的多系统药物不良反应，必须避免意外再次暴露或药物激发试验。
