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X - Systemic/Distant conditions, syndromes and reactions

DRES syndrome - DRESS-like reaction

Last update 27/03/2022

DRESS stands for 'Drug Rash, Eosinophilia, Systemic Symptoms or Syndrome'. Includes internal organ involvement (liver, bone marrow, kindney, lung, heart in the form of myocarditis (PMID 21658796)) and occasionally MOF/MODS. Respiratory involvement (in about 15% of the patients), is in the form of cough, dyspnea, wheezing, pleural effusion, pulmonary infiltrates or PIE. See also under eosinophilic pneumonia. A precise definition of the syndrome has been available since 1996 (Bocquet et al.). Earlier cases of 'Drug Hypersensitivity' in the literature likely represent authentic DRESS cases. Review and lists of causal drugs at PMID 21592453, 26354734. Reviews at PMID 23602182, 23602183, 25592341, 30140942, 32247873 Cardiac involvement: PMID 35160164

Causative drugs

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic