A Nationwide Study of Severe Cutaneous Adverse Reactions Based on the Multicenter Registry in Korea.

Autor:	Kang DY; Drug Safety Monitoring Center, Seoul National University Hospital, Seoul, Korea., Yun J; Department of Immunology and Rheumatology, Nepean Hospital, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia., Lee SY; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea., Koh YI; Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea., Sim DW; Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea., Kim S; Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea., Nam YH; Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea., Park JW; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea., Kim SH; Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea., Ye YM; Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea., Park HK; Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea., Kim MH; Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea., Jee YK; Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea., Jung JW; Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea., Yang MS; Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea., Kim SH; Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea., Lee JK; Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea., Kim CW; Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea., Hur GY; Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea., Kim MY; Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea., Park SJ; Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea., Kwon YE; Department of Internal Medicine, Chosun University Hospital, Gwangju, Korea., Choi JH; Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea., Kim JH; Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea., Kim SH; Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea., La HO; Department of Pharmacology, Catholic University of Korea, College of Medicine, Seoul, Korea., Kang MG; Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea., Park CS; Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea., Lee SM; Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea., Jeong YY; Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea., Kim HK; Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea., Jin HJ; Department of Internal Medicine, Medical school of Yeungnam University, Daegu, Korea., Jeong JW; Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea., Lee J; Department of Internal Medicine, Jeju National University Hospital, Jeju, Korea., Lee YW; Department of Internal Medicine, Catholic Kwandong University College of Medicine, Incheon, Korea., Lee SE; Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea., Kim MS; Department of Dermatology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea., Kang HR; Drug Safety Monitoring Center, Seoul National University Hospital, Seoul, Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. Electronic address: helenmed@snu.ac.kr.
Jazyk:	angličtina
Zdroj:	The journal of allergy and clinical immunology. In practice [J Allergy Clin Immunol Pract] 2021 Feb; Vol. 9 (2), pp. 929-936.e7. Date of Electronic Publication: 2020 Sep 19.
DOI:	10.1016/j.jaip.2020.09.011
Abstrakt:	Background: Because severe cutaneous adverse reactions (SCARs), such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) rarely occur, clinical data based on large-scale studies are still lacking. Objective: To provide information on culprit drugs and clinical characteristics, including morbidity and mortality of SCARs based on a nationwide registry. Methods: SCAR cases that occurred from 2010 to 2015 were recruited to the Korean SCAR registry from 34 tertiary referral hospitals. Demographics, causative drugs, causality, and clinical outcomes were collected by reviewing the medical record. Results: A total of 745 SCAR cases (384 SJS/TEN cases and 361 DRESS cases) due to 149 drugs were registered. The main causative drugs were allopurinol (14.0%), carbamazepine (9.5%), vancomycin (4.7%), and antituberculous agents (6.3%). A strong preference for SJS/TEN was observed in carbonic anhydrase inhibitors (100%), nonsteroidal anti-inflammatory drugs (84%), and acetaminophen (83%), whereas dapsone (100%), antituberculous agents (81%), and glycopeptide antibacterials (78%) were more likely to cause DRESS. The mortality rate was 6.6% (SJS/TEN 8.9% and DRESS 4.2%). The median time to death was 19 days and 29 days in SJS/TEN and DRESS respectively, and 89.8% of deaths occurred within 60 days after the onset of the skin symptoms. Conclusion: Allopurinol, carbamazepine, vancomycin, and antituberculous agents were the leading causes of SCARs in Korea. Some drugs preferentially caused a specific phenotype. The mortality rate of SCARs was 6.6%, and most of the deaths occurred within 2 months. (Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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