St George-Hyslop Frances, Cherepacha Nicole, Chugani Bindiya, Alabdeen Yousef, Sanchez-Espino Luis Fernando, Mahood Quenby, Sibbald Cathryn, Verstegen Ruud H J
Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Division of Clinical Pharmacology & Toxicology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
Clin Exp Dermatol. 2025 Jan 27;50(2):408-411. doi: 10.1093/ced/llae418.
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe adverse drug reaction with significant variation between patients concerning presenting symptoms and disease severity. Under the hypothesis that the clinical presentation of DRESS is drug specific, we performed a scoping review and identified 644 cases of paediatric DRESS. A single implicated drug was present in 262 cases, and drugs with 10 or more cases were included in this analysis (n = 224): carbamazepine (n = 86), dapsone (n = 16), lamotrigine (n = 25), phenobarbital (n = 38), phenytoin (n = 45) and trimethoprim-sulfamethoxazole (n = 14). Dapsone was associated with increased organ involvement, the highest mortality rate and the longest period of hospitalization. In addition, we showed that trimethoprim-sulfamethoxazole was associated with higher rates of autoimmune sequelae. This study confirms that drug-specific features exist and may impact the acute and long-term management of DRESS in children.
药物超敏反应伴嗜酸性粒细胞增多和全身症状（DRESS）是一种严重的药物不良反应，患者之间在症状表现和疾病严重程度方面存在显著差异。在DRESS临床表现具有药物特异性这一假设下，我们进行了一项范围综述，并确定了644例儿童DRESS病例。262例病例中存在单一的可疑药物，本分析纳入了10例或更多病例的药物（n = 224）：卡马西平（n = 86）、氨苯砜（n = 16）、拉莫三嗪（n = 25）、苯巴比妥（n = 38）、苯妥英（n = 45）和甲氧苄啶 - 磺胺甲恶唑（n = 14）。氨苯砜与器官受累增加、最高死亡率和最长住院时间相关。此外，我们表明甲氧苄啶 - 磺胺甲恶唑与自身免疫后遗症的发生率较高相关。本研究证实存在药物特异性特征，可能会影响儿童DRESS的急性和长期管理。
