Liver involvement in the drug reaction,eosinophilia,and systemic symptoms syndrome

作     者：Sylvia A Martinez-Cabriales Neil H Shear Emmanuel I Gonzalez-Moreno 

作者机构：Department of MedicineDivision of DermatologySunnybrook Health Sciences CentreUniversity of Toronto Internal Medicine DepartmentDermatology DivisionHospital Universitario "Dr. José Eleuterio González"Universidad Autónoma de Nuevo León Department of MedicineDivision of GastroenterologyUniversity of Calgary Internal Medicine DepartmentGastroenterology DivisionHospital Universitario "Dr. José Eleuterio González"Universidad Autónoma de Nuevo León 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2019年第7卷第6期

页      面：705-716页

核心收录：

学科分类：10[医学] 

主　　题：Drug reaction,eosinophilia,and systemic symptoms syndrome Severe cutaneous drug reactions Drug-induced hypersensitivity syndrome Drug-induced liver injury Acute liver failure 

摘      要：First described in 1996,the drug reaction,eosinophilia,and systemic symptoms syndrome(DReSS) is considered,along with Stevens-Johnson syndrome and toxic epidermal necrolysis,a severe cutaneous drug reaction. It is characterized by the presence of a maculopapular erythematous skin eruption,fever,lymphadenopathy,influenza-like symptoms,eosinophilia,and visceral involvement such as hepatitis,pneumonitis,myocarditis,pericarditis,nephritis,and colitis. The prognosis of patients with DReSS is related to the severity of visceral involvement. The mortality ranges from approximately 5% to 10%,and death is mainly due to liver failure,which is also the organ most commonly involved in this syndrome. Although it was previously hypothesized in 1994,DReSS syndrome can lead to reactivation of one or more human herpesvirus family members. Now being included as diagnostic criteria in a proposed diagnostic score system,this reactivation can be detected up to 2-3 wk after DReSS syndrome onset. Other causes of mortality in DReSS syndrome include myocardial or pulmonary lesions and hemophagocytosis. We reviewed the literature of previously reported case-series of DReSS and liver involvement,highlighting the pattern of liver damage,the treatment used,and the outcome.