Prevalence, risk factors, and mortality outcome in the drug reaction with eosinophilia and systemic symptoms patients with cardiac involvement.

Autor: Intarasupht, Julphat, Kanchanomai, Anchisa, Leelasattakul, Wuttirak, Chantrarat, Thoranis, Nakakes, Artit, Tiyanon, Waraporn
Předmět:
Zdroj: International Journal of Dermatology; Oct2018, Vol. 57 Issue 10, p1187-1191, 5p, 5 Charts
Abstrakt: Abstract: Background: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe cutaneous drug reaction that can affect multiple internal organ systems. Cardiac involvement in DRESS syndrome (CiDs) is uncommon but can be life‐threatening. Objective: To determine the prevalence, risk factors, and mortality outcome of CiDs. Material and methods: Forty‐one patients who were diagnosed with probable and definite DRESS syndrome according to the RegiSCAR criteria were recruited. Cardiac involvement was evaluated by two independent cardiologists. Results: The cardiac involvement was found in 8/41 (19.5%) patients. Specifically, myocardial involvement was found in five patients, while three patients had pericardial involvement. The majority of culprit drugs were antibiotics followed by anti‐epileptic medications. The hemoglobin and albumin levels were significantly lower in the patients with CiDs when compared to the patients without CiDs (P‐value = 0.005 for both factors). The mortality rate at 30 and 90 days was significantly higher among CiDs patients, that is, 3/8 (37.5%) versus 2/28 (6.1%); P‐value = 0.02 and 4/8 (50.0%) versus 2/33 (6.1%); P‐value = 0.002 respectively. Conclusion: Our study showed the prevalence of CiDs was as high as 19.5% with high mortality rate. We suggest a thorough cardiac evaluation in all DRESS patients with RegiSCAR score ≥4. The patients with CiDs had significantly lower hemoglobin and albumin levels, which might imply poor health condition, when compared to those without CiDs. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index