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Role of Multiple Comorbidities and Therapies in Conditioning the Clinical Severity of DRESS: A Mono-Center Retrospective Study of 25 Cases

DRESS/DiHS is a complex and potentially fatal drug reaction. Little is known about risk factors and elements that can help to identify patients with a severe reaction early. The aim of the study was to investigate those factors favoring the disease and its severity by analyzing the clinical conditio...

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Autores principales: Toniato, Andrea, Gamba, Chiara, Schroeder, Jan Walter, Fabbri, Valeria, Bernal Ortiz, Scarlett Valeria, Borgonovo, Linda, Piantanida, Marta, Scibilia, Joseph, Balossi, Luca, Brusamolino, Eleonora, Bonoldi, Emanuela, Caputo, Valentina, Nichelatti, Michele, Pastorello, Elide Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8268599/
https://www.ncbi.nlm.nih.gov/pubmed/34209467
http://dx.doi.org/10.3390/ijms22137072
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author Toniato, Andrea
Gamba, Chiara
Schroeder, Jan Walter
Fabbri, Valeria
Bernal Ortiz, Scarlett Valeria
Borgonovo, Linda
Piantanida, Marta
Scibilia, Joseph
Balossi, Luca
Brusamolino, Eleonora
Bonoldi, Emanuela
Caputo, Valentina
Nichelatti, Michele
Pastorello, Elide Anna
author_facet Toniato, Andrea
Gamba, Chiara
Schroeder, Jan Walter
Fabbri, Valeria
Bernal Ortiz, Scarlett Valeria
Borgonovo, Linda
Piantanida, Marta
Scibilia, Joseph
Balossi, Luca
Brusamolino, Eleonora
Bonoldi, Emanuela
Caputo, Valentina
Nichelatti, Michele
Pastorello, Elide Anna
author_sort Toniato, Andrea
collection PubMed
description DRESS/DiHS is a complex and potentially fatal drug reaction. Little is known about risk factors and elements that can help to identify patients with a severe reaction early. The aim of the study was to investigate those factors favoring the disease and its severity by analyzing the clinical conditions and therapies preceding the reaction. We conducted a retrospective analysis on patients admitted to our center between 2010 and 2020 who were discharged with a diagnosis of DRESS. We used the RegiSCAR diagnostic criteria. We defined the severity of DRESS using the criteria of Mizukawa et al. We included 25 patients (15 females) with a median age of 66 years. Skin involvement, eosinophilia, and liver injury were the most important aspects. Allopurinol was found to be the most involved drug. Reaction severity was significantly associated with the number of daily medications (p = 0.0067) and an age of at least 68 years (p = 0.013). In addition, 75% of severe cases had at least three comorbidities in history, and most of the severe cases were female. In our study the advanced age, the high number of comorbidities and home therapies, and the inflammatory state were found to be predisposing elements to the development of the disease and its severity.
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spelling pubmed-82685992021-07-10 Role of Multiple Comorbidities and Therapies in Conditioning the Clinical Severity of DRESS: A Mono-Center Retrospective Study of 25 Cases Toniato, Andrea Gamba, Chiara Schroeder, Jan Walter Fabbri, Valeria Bernal Ortiz, Scarlett Valeria Borgonovo, Linda Piantanida, Marta Scibilia, Joseph Balossi, Luca Brusamolino, Eleonora Bonoldi, Emanuela Caputo, Valentina Nichelatti, Michele Pastorello, Elide Anna Int J Mol Sci Article DRESS/DiHS is a complex and potentially fatal drug reaction. Little is known about risk factors and elements that can help to identify patients with a severe reaction early. The aim of the study was to investigate those factors favoring the disease and its severity by analyzing the clinical conditions and therapies preceding the reaction. We conducted a retrospective analysis on patients admitted to our center between 2010 and 2020 who were discharged with a diagnosis of DRESS. We used the RegiSCAR diagnostic criteria. We defined the severity of DRESS using the criteria of Mizukawa et al. We included 25 patients (15 females) with a median age of 66 years. Skin involvement, eosinophilia, and liver injury were the most important aspects. Allopurinol was found to be the most involved drug. Reaction severity was significantly associated with the number of daily medications (p = 0.0067) and an age of at least 68 years (p = 0.013). In addition, 75% of severe cases had at least three comorbidities in history, and most of the severe cases were female. In our study the advanced age, the high number of comorbidities and home therapies, and the inflammatory state were found to be predisposing elements to the development of the disease and its severity. MDPI 2021-06-30 /pmc/articles/PMC8268599/ /pubmed/34209467 http://dx.doi.org/10.3390/ijms22137072 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Toniato, Andrea
Gamba, Chiara
Schroeder, Jan Walter
Fabbri, Valeria
Bernal Ortiz, Scarlett Valeria
Borgonovo, Linda
Piantanida, Marta
Scibilia, Joseph
Balossi, Luca
Brusamolino, Eleonora
Bonoldi, Emanuela
Caputo, Valentina
Nichelatti, Michele
Pastorello, Elide Anna
Role of Multiple Comorbidities and Therapies in Conditioning the Clinical Severity of DRESS: A Mono-Center Retrospective Study of 25 Cases
title Role of Multiple Comorbidities and Therapies in Conditioning the Clinical Severity of DRESS: A Mono-Center Retrospective Study of 25 Cases
title_full Role of Multiple Comorbidities and Therapies in Conditioning the Clinical Severity of DRESS: A Mono-Center Retrospective Study of 25 Cases
title_fullStr Role of Multiple Comorbidities and Therapies in Conditioning the Clinical Severity of DRESS: A Mono-Center Retrospective Study of 25 Cases
title_full_unstemmed Role of Multiple Comorbidities and Therapies in Conditioning the Clinical Severity of DRESS: A Mono-Center Retrospective Study of 25 Cases
title_short Role of Multiple Comorbidities and Therapies in Conditioning the Clinical Severity of DRESS: A Mono-Center Retrospective Study of 25 Cases
title_sort role of multiple comorbidities and therapies in conditioning the clinical severity of dress: a mono-center retrospective study of 25 cases
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8268599/
https://www.ncbi.nlm.nih.gov/pubmed/34209467
http://dx.doi.org/10.3390/ijms22137072
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