Less Known Gastrointestinal Manifestations of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome: A Systematic Review of the Literature
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Demographic Characteristics (Age, Sex, Race) and Co-Morbidities
3.2. Medications, Eosinophilia and Latency
3.2.1. Medications
3.2.2. Eosinophilia
3.2.3. Latency
3.3. GIT Involvement
3.3.1. Pancreas in DRESS Syndrome
3.3.2. DRESS Colitis
3.3.3. DRESS Enteritis
3.3.4. DRESS Esophagitis
3.3.5. Gastric Involvement in DRESS Syndrome
3.4. Other Internal Organ Involvement in DRESS Syndrome
3.5. Viral Involvement
3.6. Therapy and Outcome
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Chronic Co-Morbid Conditions | Number of Patients |
---|---|
None | 11/51 (21.6%) |
Epilepsy/seizure disorder | 11/51 (21.6%) |
Hypertension | 7/51 (13.7%) |
Hyperuricemia/Gout | 5/51 (9.8%) |
Bipolar disorder | 4/51 (7.8%) |
Thyroid disease | 4/51 (7.8%) |
Chronic kidney disease | 4/51 (7.8%) |
Diabetes/pre-diabetes | 3/51 (5.9%) |
Arrhythmia | 2/51 (3.9%) |
Psoriatic arthritis | 2/51 (3.9%) |
Other less common comorbidities: asthma, alcohol abuse, arrhythmia, chronic heart failure, chronic cough, coronary artery disease, duodenal ulcer, dyslipidemia, idiopathic peripheral neuropathy, mitral valve prolapse, multiple myeloma, multiple sclerosis, opiate use disorder, pulmonary hypertension, pemphigus, primary sclerosing cholangitis, psoriatic arthritis, rheumatoid arthritis, schizophrenia, severe pes excavatum, trigeminal neuralgia, ulcerative colitis and tuberculosis. | All other comorbidities listed were present in only one patient. |
Medication | Number of Cases |
---|---|
Carbamazepine | 11/51 (21.6%) |
Allopurinol | 5/51 (9.8%) |
Lamotrigine | 5/51 (9.8%) |
Dapsone | 2/51 (3.9%) |
Mexiletine | 2/51 (3.9%) |
Minocycline | 2/51 (3.9%) |
Sulfasalazine | 2/51 (3.9%) |
Vancomycin | 2/51 (3.9%) |
Amoxicillin–Clavulanate | 1/51 (1.9%) |
Ciprofloxacin | 1/51 (1.9%) |
Clindamycin | 1/51 (1.9%) |
Leflunomide | 1/51 (1.9%) |
Methicillin sodium | 1/51 (1.9%) |
Methimazole | 1/51 (1.9%) |
Naproxen | 1/51 (1.9%) |
Piperacillin–Tazobactam | 1/51 (1.9%) |
Phenytoin | 1/51 (1.9%) |
Phenobarbital | 1/51 (1.9%) |
Sodium Aurothiomalate (Gold) | 1/51 (1.9%) |
Spironolactone | 1/51 (1.9%) |
Valproic acid | 1/51 (1.9%) |
Antituberculotics | 1/51 (1.9%) |
Titanium bioprothesis/Minocycline/Rifampicin | 1/51 (1.9%) |
Diclofenac/Ibuprofen | 1/51 (1.9%) |
Lamotrigine/Bupropion | 1/51 (1.9%) |
Phenytoin/Lamotrigine | 1/51 (1.9%) |
Chemotherapeutics (vincristine, doxorubicin, melphalan) | 1/51 (1.9%) |
Unspecified antibiotic | 1/51 (1.9%) |
Signs/Symptoms | Number of Cases | |
---|---|---|
Diarrhea (n = 22) | Unspecified type | 10 (19.6%) |
Non-bloody | 4 (7.8%) | |
Bloody | 4 (7.8%) | |
Watery with positive occult blood | 2 (3.9%) | |
Non-bloody becoming bloody | 2 (3.9%) | |
Vomiting | 10/51 (19.6%) | |
Abdominal pain | 8/51 (15.7%) | |
Nausea | 7/51 (13.7%) | |
Epigastric pain/chest pain ** | 3/51 (5.9%) | |
Dysphagia | 2/51 (3.9%) |
Organ Affected | Number of Cases |
---|---|
Pancreas | 29/51 (56.9%) |
Colon | 21/51 (41.2%) |
Esophagus | 4/51 (7.8%) |
Small bowel | 3/51 (5.9%) |
Stomach | 1/51 (1.9%) |
Pancreas Involvement | Number of Cases | |
---|---|---|
Acute pancreatitis | 11/29 (37.9%) | |
T1DM 18/29 (62.1%) | Sequela: autoimmune T1DM | 7/29 (24.1%) |
Sequela: fulminant T1DM | 7/29 (24.1%) | |
Admission: fulminant T1DM | 4/29 (13.8%) | |
Sequela: type 2 diabetes mellitus | 1/29 (3.4%) | |
Sequela: chronic pancreatic insufficiency | 1/29 (3.4%) |
Therapy Option | Number of Cases |
---|---|
Steroids (IV or PO) | 39/51 (76.5%) |
Antihistamines | 5/51 (9.8%) |
IVIG | 5/51 (9.8%) |
Ganciclovir | 3/51 (5.9%) |
Plasma exchange | 2/51 (3.9%) |
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Jevtic, D.; Dumic, I.; Nordin, T.; Singh, A.; Sulovic, N.; Radovanovic, M.; Jecmenica, M.; Milovanovic, T. Less Known Gastrointestinal Manifestations of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome: A Systematic Review of the Literature. J. Clin. Med. 2021, 10, 4287. https://doi.org/10.3390/jcm10184287
Jevtic D, Dumic I, Nordin T, Singh A, Sulovic N, Radovanovic M, Jecmenica M, Milovanovic T. Less Known Gastrointestinal Manifestations of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome: A Systematic Review of the Literature. Journal of Clinical Medicine. 2021; 10(18):4287. https://doi.org/10.3390/jcm10184287
Chicago/Turabian StyleJevtic, Djordje, Igor Dumic, Terri Nordin, Amteshwar Singh, Nadezda Sulovic, Milan Radovanovic, Mladen Jecmenica, and Tamara Milovanovic. 2021. "Less Known Gastrointestinal Manifestations of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome: A Systematic Review of the Literature" Journal of Clinical Medicine 10, no. 18: 4287. https://doi.org/10.3390/jcm10184287