Liver injury in patients with DRESS: A clinical study of 72 cases - 16/05/15
Abstract |
Background |
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a syndrome involving multiple systems. Liver injury is the most common visceral manifestation.
Objective |
The purpose of this study was to investigate the types of liver injury and factors associated with DRESS.
Methods |
A retrospective cohort study was conducted in Taiwan using a DRESS database compiled from December 2000 to March 2013.
Results |
Seventy-two cases were included in this study. Among them, 62 (86.1%) cases involved liver injury, 6 of which (9.7%) were liver injury before skin presentation. The distribution of liver injury patterns at initial presentation was 23 cholestatic type (37.1%), 17 mixed type (27.4%), and 12 hepatocellular type (19.4%). Patients with hepatocellular-type injuries were younger, with a median age of 31.5 (P = .044). Individuals with liver function results more than 10 times the upper limit were more likely to have fever (P = .026), took more time to recover, and had fewer eosinophils in the dermis (P = .002).
Limitations |
The study was a retrospective cohort study with limited cases.
Conclusions |
Liver injury is common in DRESS and frequently associated with atypical lymphocytosis. The cholestatic type is the most common type. Patients with cholestatic-type injuries were older and more frequently had interface changes in skin pathology.
Le texte complet de cet article est disponible en PDF.Key words : drug-induced hypersensitivity syndrome, drug reaction with eosinophilia and systemic symptoms, drug eruption, interface change, liver injury
Abbreviations used : AEDs, Allopurinol-DRESS, ALP, ALT, AST, Carbamazepine-DRESS, DILI, DRESS, PED, Phenytoin-DRESS, RBC, SD, SMX-TMP, Sulfonamide/sulfones-DRESS, ULNs
Plan
| Funding sources: This work was supported by the National Science Council Taiwan (NSC 99-2628-B-002 -084 -MY3), National Taiwan University Hospital (NTUH 100N-1768 & 102-S2058) and National Taiwan University Hospital Hsin-Chu Branch (HCH103-025 & HCH104-050). |
|
| Conflicts of interest: None declared. |
Vol 72 - N° 6
P. 984-991 - juin 2015 Retour au numéro
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