C-Reactive Protein and Procalcitonin in Case Reports of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome
| Autor: | Kathrin Scherer, Martina Schaueblin, Anne Leuppi-Taegtmeyer, Simona T Hübner, Alexandra E. Rätz Bravo, Alessandro Ceschi, Raffaela Bertoli, Manuel Haschke |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Calcitonin Male medicine.medical_specialty Adolescent Immunology Inflammation Gastroenterology Drug reaction with eosinophilia and systemic symptoms Procalcitonin Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine Liver enzyme Epidemiology medicine Humans Immunology and Allergy Child Aged Retrospective Studies Aged 80 and over Receiver operating characteristic biology business.industry C-reactive protein General Medicine Middle Aged medicine.disease C-Reactive Protein ROC Curve 030220 oncology & carcinogenesis Drug Hypersensitivity Syndrome biology.protein Biomarker (medicine) Female medicine.symptom business Biomarkers Switzerland 030217 neurology & neurosurgery |
| Zdroj: | International Archives of Allergy and Immunology. 176:44-54 |
| ISSN: | 1423-0097 1018-2438 |
| DOI: | 10.1159/000487670 |
| Popis: | Background: The spectrum of inflammatory marker response in DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome has not been systematically characterized. Methods: An epidemiological biomarker study of C-reactive protein (CRP) and procalcitonin (PCT) values in patients with DRESS syndrome reported at 2 regional pharmacovigilance centers in Switzerland or published in the medical literature 2008–2016 was performed. Results: Ninety-four DRESS cases were studied. All cases showed a CRP value > 10 mg/L (the upper limit of normal). The mean CRP value was 109.2 ± 79.4 mg/L. CRP values were significantly higher in 22 cases where a cause of inflammation besides DRESS could not be excluded (mean 162.1 vs. 92.9 mg/L; p = 0.003). Receiver operator characteristics curve analysis showed a moderate performance with a CRP cut-off value of 99.4 mg/L (AUC 0.717) to distinguish between patients with and without a possible additional cause of inflammation. The mean and median PCT values were 2.44 ± 5.94 and 0.69 ng/mL, respectively (n = 25 patients). Patients in whom an additional cause of inflammation besides DRESS could not be excluded showed a median PCT of 1.37 ng/mL (n = 9) versus 0.67 ng/mL (n = 16) in patients with DRESS only. PCT values were above the normal cut-off of 0.1 ng/mL, suggestive of bacterial infection in all but 1 case. Furthermore, there was a correlation between PCT values and hepatic enzyme measurements. Conclusions: Evaluating CRP and PCT values might be of use in helping physicians to distinguish between cases of DRESS syndrome with and without concurrent infection or other causes of inflammation. Further prospective investigation is required to define the use of these inflammatory markers in the management of DRESS. |
| Databáze: | OpenAIRE |
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