395 Clinical Features of Dress Syndrome in 42 Patients

BACKGROUND: The clinical features of DRESS syndrome are complicated, and the incidence this condition is very low. METHODS: This study was a retrospective analysis of prospectively collected data in 42 consecutive patients with DRESS syndrome diagnosed between September 2009 and April 2011. We investigated the clinical features, response to treatment, and outcome of 42 patients. RESULTS: Study patients consisted of 18 men (42.9%) and 24 women (57.1%). The most common causative drugs were antibiotics (33.3%) and anticonvulsants (26.2%), followed by antituberculosis drugs (11.9%), allopurinol (7.1%), nonsteroidal anti-inflammatory drugs (NSAIDs) (7.1%), undetermined agents (7.1%), others (7.1%). The latency period ranged from 2 to 60 days, with a mean of 16.6 days. The longest latency period was noted in the antituberculosis drug group, 35.8 ± 16.2 days. Atypical lymphocytosis was noted in 16 patients (38.1%), and thrombocytopenia in 7 patients (16.7%). Hepatic involvement was noted in all study patients. Additionally, lung involvement was noted in 2 patients (5.8%), CNS involvement was in 1 patient (2.4%). Systemic corticosteroids were administered to 8 patients (19.0%). Complete recovery was noted in 40 patients (95.2%). Two patients had poor outcomes; one died due to opportunistic infection secondary to long-term systemic corticosteroids treatment and the other showed prorgressive deterioration of liver damage, although the final outcome is not known. CONCLUSIONS: Drugs associated with DRESS syndrome were variable and most frequently included antibiotics and anticonvulsants. DRESS syndrome was more common than generally recognized, and most of patients with this disease showed better clinical out outcome than that has been generally expected.