Antiviral Induced Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Dyndrome: A Literature Review

  • Shiva Sharifzadeh 1Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Sepideh Elyasi 1Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Amir Hooshang Mohammadpour 1Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Background: Drug reaction with eosinophilia and systemic symptoms syndrome (DRESS) is a delayed infrequent potentially life-threatening idiosyncratic drug reaction. Fever, rash, lymphadenopathy, hematological findings (e.g. eosinophilia & leukocytosis), and abnormal liver function tests are its common features. Aromatic anticonvulsants and allopurinol are the most frequent causative agents. However, various reports of antimicrobial agents induced DRESS including antiviral agents are available. In this review, we try to summarize reports of antiviral induced DRESS syndrome.  

Methods: The data were collected by searching PubMed, ScienceDirect, Google Scholar, Scopus, Cochrane database systematic reviews, and Islamic World Science Citation Center (ISC). The Keywords used as search terms were “DRESS syndrome”, “drug-induced hypersensitivity reaction (DIHS)”, “antiviral”, and names of various antiviral agents. Finally, a total of 28 relevant articles up to the date of publication were included for review.

Results and conclusion: Totally, 30 Cases of antiviral induced DRESS is reported. European registry on severe cutaneous adverse drug reactions (RegiSCAR) was the usual used clinical diagnostic criteria. Most of the reports are related to, telaprevir. Rash and fever actually occurred in a large number of these patients. Eosinophilia was the most reported hematologic involvement. Liver injury is the most defined type of organ damage. Renal involvement is usually mild and will be recovered after medication discontinuation without permanent sequelae. Most of the patients managed with systemic corticosteroids including both oral and parenteral forms. The death occurred in 1 patient from liver decompensation. The reactivation various viruses especially HHV-6 is reported in 2 Cases. The minimum and maximum latency periods respectively were 10 and 330 days after drug administration. It is necessary to perform more studies, especially those focused on the association between DRESS syndrome and viral reactivation and also its effective management.

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Published
2020-03-24
How to Cite
1.
Sharifzadeh S, Elyasi S, Mohammadpour AH. Antiviral Induced Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Dyndrome: A Literature Review. J Pharm Care. 8(1):35-47.
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Review Article(s)