Department of Dermatology, University of Toronto, Toronto, Canada.
Department of Dermatology, Autonomous University of Nuevo Leon, Monterrey, Mexico.
Am J Clin Dermatol. 2019 Apr;20(2):217-236. doi: 10.1007/s40257-018-00416-4.
Drug reaction with eosinophilia and systemic symptoms (DReSS), also known as drug-induced hypersensitivity syndrome (DiHS), is an uncommon severe adverse reaction to medications. It is important to recognize it as it is potentially fatal and can cause significant morbidity. From the first reports of drug reactions related to certain anticonvulsants characterized by fever, liver enzyme elevation, and skin changes, our continuously growing understanding of this entity has allowed us to describe its physiopathology and clinical features even further. The relationship of genetic factors, viral activation, and specific drug exposure is now known to play a role in this disease. There is still not a widely accepted marker for DReSS/DiHS, but the spectrum of clinical and laboratory features has now been better outlined. The mainstay of treatment is the use of systemic corticosteroids, but other options such as intravenous immunoglobulin, cyclosporine, mycophenolate mofetil, rituximab, and cyclophosphamide have been described. We present a comprehensive review of the literature on DReSS/DiHS, focusing on its history, etiopathogenesis, diagnosis, therapeutic approach, and outcome.
药物反应伴嗜酸性粒细胞增多和全身性症状（DReSS），又称药物诱导的超敏反应综合征（DiHS），是一种罕见的严重药物不良反应。认识到这一点很重要，因为它可能是致命的，并会导致严重的发病率。从最初报道的与某些抗惊厥药相关的药物反应开始，这些反应的特征是发热、肝酶升高和皮肤改变，我们对这一实体的不断深入了解使我们能够进一步描述其病理生理学和临床特征。遗传因素、病毒激活和特定药物暴露之间的关系现已被证明在这种疾病中起作用。目前还没有广泛接受的 DReSS/DiHS 标志物，但现在已经更好地描述了临床和实验室特征的范围。治疗的主要方法是使用全身性皮质类固醇，但也有其他选择，如静脉注射免疫球蛋白、环孢素、霉酚酸酯、利妥昔单抗和环磷酰胺。我们全面回顾了 DReSS/DiHS 的文献，重点介绍了其历史、病因发病机制、诊断、治疗方法和结局。
