Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 16:15:1490334.
doi: 10.3389/fimmu.2024.1490334. eCollection 2024.

Fatal outcome related to drug reaction with eosinophilia and systemic symptoms: a disproportionality analysis of FAERS database and a systematic review of cases

Chunsu Liang  1   2 , Pengjiao An  1   2 , Yizhou Zhang  1   2 , Xin Liu  1   2 , Bo Zhang  1   2
Affiliations

Fatal outcome related to drug reaction with eosinophilia and systemic symptoms: a disproportionality analysis of FAERS database and a systematic review of cases

Chunsu Liang et al. Front Immunol. .

Abstract

Background: Drug rash with eosinophilia and systemic symptoms (DRESS) is a life-threatening severe cutaneous adverse reaction.

Objective: This study aims to study fatal DRESS cases using FAERS database and systematic review.

Methods: Data of the FDA Adverse Event Reporting System (FAERS) database were extracted and manipulated. Articles from Pubmed, Embase and CINAHL databases were screened.

Results: 0.13% of the adverse events submitted to FAERS was identified as DRESS and the percentage of fatal cases was up to 6.62%. The top five drugs calculated to induce DRESS with the highest number of reported cases were allopurinol, lamotrigine, vancomycin, amoxicillin and carbamazepine. The top five drugs statistically related to fatal outcome with the highest number of reported cases were allopurinol, vancomycin, trimethoprim, sulfamethoxazole and lamotrigine. Skin manifestations remained the main reason for admission and the average time from dose to rash onset was 27.19 days. The most commonly cited culprit medication type were antibiotics (50.00%), anti-gout agents (15.38%) and anti-epileptic drug (11.54%).

Conclusions: We discussed fatal cases of DRESS through FAERS system and case reports, hoping to raise awareness when using relevant drugs.

Keywords: FDA adverse event reporting system; disproportionality analysis; drug adverse reaction; drug reaction with eosinophilia and systemic symptoms; drug-induced hypersensitivity syndrome; fatal cases; systematic review.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The detailed flow chart of the literature search.
Figure 2
Figure 2
Causative drugs related to fatal outcome of DRESS cases.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Husain Z, Reddy BY, Schwartz RA. DRESS syndrome: Part I. Clinical perspectives. J Am Acad Dermatol. (2013) 68:e1–14. doi: 10.1016/j.jaad.2013.01.033 - DOI - PubMed
    1. Wei BM, Fox LP, Kaffenberger BH, Korman AM, Micheletti RG, Mostaghimi A, et al. . Drug-induced hypersensitivity syndrome / drug reaction with eosinophilia and systemic symptoms. Part I. Epidemiology, pathogenesis, clinicopathological features, and prognosis. J Am Acad Dermatol. (2024) 90(5):885–908. doi: 10.1016/j.jaad.2023.02.072 - DOI - PubMed
    1. Kardaun SH, Sidoroff A, Valeyrie-Allanore L, Halevy S, Davidovici BB, Mockenhaupt M, et al. . Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist? Br J Dermatol. (2007) 156:609–11. doi: 10.1111/j.1365-2133.2006.07704.x - DOI - PubMed
    1. Yaylacı S, Demir MV, Temiz T, Tamer A, Uslan MI. Allopurinol-induced DRESS syndrome. Indian J Pharmacol. (2012) 44:412–4. doi: 10.4103/0253-7613.96351 - DOI - PMC - PubMed
    1. Choi HG, Byun J, Moon CH, Yoon JH, Yang KY, Park SC, et al. . Allopurinol-induced DRESS syndrome mimicking biliary obstruction. Clin Mol Hepatol. (2014) 20:71–5. doi: 10.3350/cmh.2014.20.1.71 - DOI - PMC - PubMed

Publication types

LinkOut - more resources