How is DRESS syndrome diagnosed?
The diagnosis of DRESS syndrome is complex and often requires evaluation from a physician before ruling out other causes. DRESS syndrome should be suspected if a diffuse rash erupts and is accompanied by fever, facial edema, and enlarged lymph two to six weeks after starting a new high-risk medication.
Does DRESS syndrome go away?
With early diagnosis and treatment, most people recover completely, but some may have permanent organ damage or develop an autoimmune disease after DRESS syndrome symptoms resolve.
How long can DRESS syndrome last?
Hallmarks of DRESS syndrome include a long latency period between initiation of the inciting medication and onset of the reaction (>2-3 weeks), fever, rash, and involvement of at least one internal organ system. Withdrawal of the inciting medication and systemic corticosteroids are mainstays of therapy.
What is the cause of DRESS syndrome?
The syndrome is thought to be caused by an allopurinol metabolite oxypurinol, which increases in concentration in renal impairment or with the use of diuretics. Genetic factors are also important. The risk of DRESS may be as high as 25% for individuals who have a first degree relative who has experienced this syndrome.
What drugs can cause eosinophilia?
Drug reaction with eosinophilia and systemic symptoms (DRESS) can occur with sulfasalazine, hydantoin, carbamazepine, d-penicillamine, allopurinol, hydrochlorothiazide, and cyclosporine, associated with viral infection (human herpesvirus-6, Epstein-Barr virus, cytomegalovirus) 69,125,133.
What is the treatment for DRESS syndrome?
Topical corticosteroids can be used for symptomatic relief, but systemic steroid therapy is generally required. Other immunosuppressants have also been employed in treatment and show promise in future therapy.
Is DRESS syndrome an emergency?
Since DRESS syndrome can have such a varied presentation, one important differentiation that should be made is between DRESS and Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN). SJS/TEN is a more acute and life-threatening dermatological emergency, so it is important diagnose early.
What doctor treats eosinophilia?
An allergist, who treats asthma and allergies. An immunologist, who treats problems with the immune system, including allergies. A pulmonologist, who treats lung diseases.
How is eosinophilia diagnosed?
Blood eosinophilia may be detected with a blood test, usually as part of a complete blood count. A count of more than 500 eosinophils per microliter of blood is generally considered eosinophilia in adults.
How long does it take to recover from DRESS syndrome?
The average time to recovery is six to nine weeks. Long term, most patients do well, although some patients can go on to develop autoimmune diseases so additional monitoring should be considered. 1.
How do you treat DRESS syndrome?
How do you diagnose eosinophilia?