医学
重症监护室
内科学
回顾性队列研究
中毒性表皮坏死松解
罪魁祸首
Exanthem公司
红皮病
皮疹
逻辑回归
嗜酸性粒细胞增多症
儿科
皮肤病科
心肌梗塞
作者
Khalaf Kridin,Marie‐Charlotte Brüggen,Sarah Walsh,Benoît Bensaïd,Annamari Ranki,Eva Oppel,Damian Meyersburg,Ser-Ling Chua,Corsin Seeli,Heidi Sandberg,Lars E. French,Artem Vorobyev,S. Oro
摘要
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare but potentially fatal drug hypersensitivity reaction.To explore treatment approaches across Europe and their impact on the disease course, as well as prognostic factors and culprit drugs.In this retrospective European multicentric study, we included patients with probable or certain DRESS (RegiSCAR score ≥ 4) between January 2016 and December 2020. Independent associations between clinical parameters and the risk of intensive care unit admission and mortality at three months were assessed using a multivariable-adjusted logistic regression model.A total of 141 patients from 8 tertiary centres were included. Morbilliform exanthem was the most frequent cutaneous manifestation (78.0%). The mean affected body surface area (BSA) was 67%, 42% of the patients presented with erythroderma, and 24.8% had mucosal involvement. Based on systemic involvement, 31.9% of the patients had a severe DRESS. Anticonvulsants (24.1%) and sulphonamides (22.0%) were the most frequent causative agents. In all, 73% of the patients were treated with systemic glucocorticoids, and 25.5% received topical corticosteroids as monotherapy. Few patients received antiviral drugs or anti-IL5. No patients received intravenous immunoglobulins. The overall mortality was 7.1%. Independent predictors of mortality were older age (≥57.0 years; fully adjusted OR, 9.80; 95% CI, 1.20-79.93; p = 0.033), kidney involvement (fully adjusted OR, 4.70; 95% CI, 1.00-24.12; p = 0.049), and admission in intensive care unit (fully adjusted OR, 8.12; 95% CI, 1.90-34.67; p = 0.005). Relapse of DRESS and delayed autoimmune sequelae occurred in 8.5% and 12.1% of patients, respectively.This study underlines the need for diagnostic and prognostic scores/markers as well as for prospective clinical trials of drugs with the potential to reduce mortality and complications of DRESS.
科研通智能强力驱动
Strongly Powered by AbleSci AI