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Current Perspective Regarding the Immunopathogenesis of Drug-Induced Hypersensitivity Syndrome/Drug Reaction with Eosinophilia and Systemic Symptoms (DIHS/DRESS)
 
 
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Volume 22
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Article

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

by
Andrea Toniato
1,*,
Chiara Gamba
1,
Jan Walter Schroeder
1,
Valeria Fabbri
1,
Scarlett Valeria Bernal Ortiz
1,
Linda Borgonovo
1,
Marta Piantanida
1,
Joseph Scibilia
1,
Luca Balossi
1,
Eleonora Brusamolino
1,
Emanuela Bonoldi
2,
Valentina Caputo
2,
Michele Nichelatti
3 and
Elide Anna Pastorello
1
1
Unit of Allergology and Immunology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
2
Unit of Pathological Anatomy and Cytogenetics, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
3
Service of Biostatistics, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2021, 22(13), 7072; https://doi.org/10.3390/ijms22137072
Submission received: 14 June 2021 / Revised: 24 June 2021 / Accepted: 27 June 2021 / Published: 30 June 2021
(This article belongs to the Special Issue Skin Allergy and Immunology)
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Abstract

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.
Keywords: DRESS syndrome; drug reaction with eosinophilia and systemic symptoms; drug-induced hypersensitivity syndrome; SCAR; severity; risk factors; comorbidities DRESS syndrome; drug reaction with eosinophilia and systemic symptoms; drug-induced hypersensitivity syndrome; SCAR; severity; risk factors; comorbidities

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MDPI and ACS Style

Toniato, A.; Gamba, C.; Schroeder, J.W.; Fabbri, V.; Bernal Ortiz, S.V.; Borgonovo, L.; Piantanida, M.; Scibilia, J.; Balossi, L.; Brusamolino, E.; et al. Role of Multiple Comorbidities and Therapies in Conditioning the Clinical Severity of DRESS: A Mono-Center Retrospective Study of 25 Cases. Int. J. Mol. Sci. 2021, 22, 7072. https://doi.org/10.3390/ijms22137072

AMA Style

Toniato A, Gamba C, Schroeder JW, Fabbri V, Bernal Ortiz SV, Borgonovo L, Piantanida M, Scibilia J, Balossi L, Brusamolino E, et al. Role of Multiple Comorbidities and Therapies in Conditioning the Clinical Severity of DRESS: A Mono-Center Retrospective Study of 25 Cases. International Journal of Molecular Sciences. 2021; 22(13):7072. https://doi.org/10.3390/ijms22137072

Chicago/Turabian Style

Toniato, Andrea, Chiara Gamba, Jan Walter Schroeder, Valeria Fabbri, Scarlett Valeria Bernal Ortiz, Linda Borgonovo, Marta Piantanida, Joseph Scibilia, Luca Balossi, Eleonora Brusamolino, and et al. 2021. "Role of Multiple Comorbidities and Therapies in Conditioning the Clinical Severity of DRESS: A Mono-Center Retrospective Study of 25 Cases" International Journal of Molecular Sciences 22, no. 13: 7072. https://doi.org/10.3390/ijms22137072

APA Style

Toniato, A., Gamba, C., Schroeder, J. W., Fabbri, V., Bernal Ortiz, S. V., Borgonovo, L., Piantanida, M., Scibilia, J., Balossi, L., Brusamolino, E., Bonoldi, E., Caputo, V., Nichelatti, M., & Pastorello, E. A. (2021). Role of Multiple Comorbidities and Therapies in Conditioning the Clinical Severity of DRESS: A Mono-Center Retrospective Study of 25 Cases. International Journal of Molecular Sciences, 22(13), 7072. https://doi.org/10.3390/ijms22137072

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