What Is the Treatment for DRESS Syndrome?

Drug-induced hypersensitivity syndrome (DIHS), also known as drug rash with eosinophilia and systemic symp toms (DRESS) or delayed multiple organs caused by drugs Drug-induced delayed multiorgan hypersensitivity syndrome (D IDMOHS) is an acute severe adverse drug reaction with a triad of fever, rash, and visceral involvement.

Drug hypersensitivity syndrome

This entry lacks an overview map . Supplementing related content makes the entry more complete and can be upgraded quickly. Come on!

Drug-induced hypersensitivity syndrome (DIHS), and

The exact incidence of DRESS is unknown (of which anti-

There are mainly the diagnostic criteria of the Japanese Drug Review Group in 2006 and the 2007 RegiSCAR diagnostic criteria. Diagnostic Criteria of the Japanese Drug Review Group (2006)

Macular papules that appear more than 3 weeks after using certain drugs

After discontinuing the disease-causing drugs, symptoms persist for more than 2 weeks

Body temperature is higher than 38

with liver damage (glutamate aminotransferase> 100 U / L)

accompanied by more than one of the following hematological changes:

a. Increased white blood cells (> 11 × 109 / L)

b. The appearance of heteromorphic lymphocytes (> 5%)

c. Eosinophils increased (> 1. 5 × 109 / L)

Lymph node enlargement

HHV-6 reactivated

Typical D IHS / DRESS: All items listed above; Atypical DHS: (1 to 5) items, of which the fourth item can also show damage to other organs (such as kidney damage).

Early diagnosis is a key step in treatment and it is also critical to the patient's prognosis. mainly include:

1 Routine treatment Immediately discontinue allergenic drugs, hospitalization, drink more water or infusion to promote the excretion of allergenic drugs. At the same time, it is necessary to avoid experimental application of antibiotics or non-steroidal anti-inflammatory drugs in the acute phase, so as to avoid cross-reactions between the drugs to mask the original clinical symptoms or exacerbate the original symptoms. Also need to avoid the application of similar drugs.

2 Application of glucocorticoids The starting dose of glucocorticoids can be determined according to the different drugs caused, the underlying disease situation and the age of the patient. Methylprednisolone 1 g / d intravenous drip is usually used; for patients with low immune function or severe infection, it is recommended to use a half-volume shock first, that is, methylprednisolone 0.5 g / d intravenous drip for 3 days, and then changed to Methylprednisolone 1g / d, intravenous drip for 3 consecutive days. Then gradually decrease. There is also a commonly used dose of prednisolone (40-60) mg / d, which is adjusted according to clinical manifestations. Hormones usually take weeks to months. It has been reported that the concurrent application of the immunosuppressant cyclophosphamide will make the disease worse. Therefore, the application of immunosuppressive agents should be carefully considered in the clinical application of large doses of hormones.

3 Intravenous immunoglobulin is suitable for patients with immunocompromised or severe infections who are not suitable for glucocorticoid shock therapy and severe DRESS patients who are not effective with glucocorticoid shock therapy.High-dose immunoglobulin therapy should be used. (10 20) g / d, that is (0.2 0.4) g / (kg · d), intravenous drip for 3 days; if the effect is not obvious, the dose can be increased to (30 40) g / d That is (0.6 to 0.8) g / (kg · d) for 3 days. Combination of glucocorticoids is superior to immunoglobulin high-dose shock therapy alone.

4 Antiviral therapy for HHV-6 reactivation, especially for DRESS with cerebrospinal meningitis, antiviral is very important.

Born, how to live? A cry from the heart of a father2013-01-08

Wulian China News Unexpected events, life is actually very fragile, a lively and cute child suddenly suffered from such illness and suffering, now hovering on the edge of life and death! Eating a meal became his biggest wish, knowing that he was just a three-year-old child!