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药物超敏反应伴嗜酸性粒细胞增多和全身症状(DRESS)后的自身免疫性疾病、终末器官功能障碍及药物不良反应:一项回顾性队列研究

Autoimmune Diseases, End Organ Dysfunction and Adverse Drug Reaction Following Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): A Retrospective Cohort Study.

作者信息

Sasidharanpillai Sarita, Joseph Amala Theresa, Ajithkumar Kidangazhiathmana, Devi Keerankulangara

机构信息

Department of Dermatology and Venereology, Government Medical College, Kozhikode, Kerala, India.

Department of Dermatology and Venereology, Government Medical College, Thrissur, Kerala, India.

出版信息

Indian Dermatol Online J. 2021 Aug 2;12(5):722-725. doi: 10.4103/idoj.IDOJ_786_20. eCollection 2021 Sep-Oct.

Abstract

CONTEXT

Autoimmune diseases, organ dysfunction and new drug allergies are mentioned as long-term complications after DRESS. There is scarcity of data on this from the country.

AIMS

To determine the frequency of autoimmune diseases, organ dysfunction, and new drug allergies after the resolution of DRESS.

SETTINGS AND DESIGN

This retrospective cohort study was carried out among patients who received treatment for DRESS in a tertiary referral center.

MATERIALS AND METHODS

In this retrospective cohort study, DRESS patients who received inpatient care in the dermatology department of our tertiary referral center from August 2014 to February 2017 were included. We excluded patients aged 12 years or below and those who had not completed minimum two years after the resolution of DRESS as on December 2019. We collected information on new onset autoimmune disease, end organ damage and new drug allergies detected after the resolution of DRESS through a telephonic interview. Those who consented were evaluated in our department.

RESULTS

We could contact 40/50 (80%) identified individuals and all of them consented for telephonic interview. 17 patients gave consent for revaluation in our department. There were 22 females and 18 males. 17 had definite and 23 had probable DRESS. The frequency of detection of a new disease and a new drug allergy after DRESS was 10% (4/40) and 7.5% (3/40), respectively. We noted three (7.5%) autoimmune diseases (rheumatoid arthritis 1, alopecia areata 1, chronic autoimmune urticaria 1) and one end organ damage (chronic kidney disease) among the study participants.

LIMITATIONS

Small sample size and retrospective study design were the limitations.

CONCLUSIONS

Prospective studies with large sample size are needed to delineate the link between DRESS and autoimmunity, end organ damage, and new drug allergies.

摘要

背景

自身免疫性疾病、器官功能障碍和新药过敏被提及为药物超敏反应伴嗜酸性粒细胞增多和系统症状(DRESS)后的长期并发症。该国关于这方面的数据稀缺。

目的

确定DRESS消退后自身免疫性疾病、器官功能障碍和新药过敏的发生率。

设置与设计

这项回顾性队列研究是在一家三级转诊中心接受DRESS治疗的患者中进行的。

材料与方法

在这项回顾性队列研究中,纳入了2014年8月至2017年2月在我们三级转诊中心皮肤科接受住院治疗的DRESS患者。我们排除了12岁及以下的患者以及截至2019年12月DRESS消退后未完成至少两年随访的患者。我们通过电话访谈收集了DRESS消退后新出现的自身免疫性疾病、终末器官损害和新药过敏的信息。同意的患者在我们科室进行评估。

结果

我们能够联系到40/50(80%)确定的个体,他们都同意接受电话访谈。17名患者同意在我们科室进行重新评估。有22名女性和18名男性。17例为确诊的DRESS,23例为可能的DRESS。DRESS后新疾病和新药过敏的检出率分别为10%(4/40)和7.5%(3/40)。我们在研究参与者中注意到3例(7.5%)自身免疫性疾病(类风湿关节炎1例、斑秃1例、慢性自身免疫性荨麻疹1例)和1例终末器官损害(慢性肾脏病)。

局限性

样本量小和回顾性研究设计是局限性。

结论

需要进行大样本量的前瞻性研究来阐明DRESS与自身免疫、终末器官损害和新药过敏之间的联系。

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Curr Opin Allergy Clin Immunol. 2013 Aug;13(4):323-9. doi: 10.1097/ACI.0b013e3283630c36.

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