Drug-specific presentation and outcome of drug reaction with eosinophilia and systemic symptoms (DRESS) in children: a scoping review.

Abstract

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe adverse drug reaction with significant variation between patients concerning presenting symptoms and disease severity. Under the hypothesis that the clinical presentation of DRESS is drug specific, we performed a scoping review and identified 644 cases of paediatric DRESS. A single implicated drug was present in 262 cases, and drugs with 10 or more cases were included in this analysis (n = 224): carbamazepine (n = 86), dapsone (n = 16), lamotrigine (n = 25), phenobarbital (n = 38), phenytoin (n = 45) and trimethoprim-sulfamethoxazole (n = 14). Dapsone was associated with increased organ involvement, the highest mortality rate and the longest period of hospitalization. In addition, we showed that trimethoprim-sulfamethoxazole was associated with higher rates of autoimmune sequelae. This study confirms that drug-specific features exist and may impact the acute and long-term management of DRESS in children.