X.a
DRES syndrome - DRESS-like reaction
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
86
Sulindac
I.c
I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) VII.a VII - Mediastinal involvement
VII.a - Lymphadenopathy (intrathoracic) X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.u X - Systemic/Distant conditions, syndromes and reactions
X.u - Multiple organ dysfunction/failure (MODS/MOF)
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.d I - Interstitial/parenchymal lung disease
I.d - Organizing pneumonia pattern (an area or areas of consolidation on imaging) VII.a VII - Mediastinal involvement
VII.a - Lymphadenopathy (intrathoracic) X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.u X - Systemic/Distant conditions, syndromes and reactions
X.u - Multiple organ dysfunction/failure (MODS/MOF)
1
Tricyclic antidepressants - Tricyclic antidepressant poisoning
I.c
I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.g I - Interstitial/parenchymal lung disease
I.g - Pulmonary fibrosis II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury V.b V - Pleural and/or pericardial involvement
V.b - Eosinophilic pleural effusion X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction XII.m XII - Cardiovascular involvement / toxicity
XII.m - Cardiac- cardiorespiratory/pulmonary arrest XII.n XII - Cardiovascular involvement / toxicity
XII.n - Cardiovascular collapse - Cardiogenic shock - Hypotension XII.ai XII - Cardiovascular involvement / toxicity
XII.ai - Cardiotoxicity
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.g I - Interstitial/parenchymal lung disease
I.g - Pulmonary fibrosis II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury V.b V - Pleural and/or pericardial involvement
V.b - Eosinophilic pleural effusion X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction XII.m XII - Cardiovascular involvement / toxicity
XII.m - Cardiac- cardiorespiratory/pulmonary arrest XII.n XII - Cardiovascular involvement / toxicity
XII.n - Cardiovascular collapse - Cardiogenic shock - Hypotension XII.ai XII - Cardiovascular involvement / toxicity
XII.ai - Cardiotoxicity
1
Trimethoprim sulfamethoxazole (TMP-SMX)
I.a
I - Interstitial/parenchymal lung disease
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) I.f I - Interstitial/parenchymal lung disease
I.f - Acute fibrinous organizing pneumonia (AFOP) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury II.u II - Pulmonary edema - Acute lung injury - ARDS
II.u - Acute respiratory failure (e.g. from ARDS, ILD, PIE, OP, pulmonary edema or bronchospasm) requiring ECMO V.f V - Pleural and/or pericardial involvement
V.f - Pneumothorax X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.e X - Systemic/Distant conditions, syndromes and reactions
X.e - Autoimmunity-Autoimmune conditions (+ANA, +anti-ds-DNA, +ANCAs, other auto-Abs) X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.g X - Systemic/Distant conditions, syndromes and reactions
X.g - Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement) X.x X - Systemic/Distant conditions, syndromes and reactions
X.x - Subclinical ANCA positivity XIV.a XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.a - Methemoglobinemia XV.b XV - Pathology
XV.b - Path: Eosinophilic pneumonia (subacute or acute) (see also Ic) XV.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL) XV.ct XV - Pathology
XV.ct - Path: Delayed alveolar injury with delayed epithelialization (DAIDE) XVI.bb XVI - Imaging
XVI.bb - Imaging: Pneumomediastinum XIX.c XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.c - BAL: An excess proportion of eosinophils
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) I.f I - Interstitial/parenchymal lung disease
I.f - Acute fibrinous organizing pneumonia (AFOP) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) II.b II - Pulmonary edema - Acute lung injury - ARDS
II.b - ARDS - Acute lung injury II.u II - Pulmonary edema - Acute lung injury - ARDS
II.u - Acute respiratory failure (e.g. from ARDS, ILD, PIE, OP, pulmonary edema or bronchospasm) requiring ECMO V.f V - Pleural and/or pericardial involvement
V.f - Pneumothorax X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.e X - Systemic/Distant conditions, syndromes and reactions
X.e - Autoimmunity-Autoimmune conditions (+ANA, +anti-ds-DNA, +ANCAs, other auto-Abs) X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.g X - Systemic/Distant conditions, syndromes and reactions
X.g - Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement) X.x X - Systemic/Distant conditions, syndromes and reactions
X.x - Subclinical ANCA positivity XIV.a XIV - Hemoglobinopathies - Abnormal hemoglobin states (acquired)
XIV.a - Methemoglobinemia XV.b XV - Pathology
XV.b - Path: Eosinophilic pneumonia (subacute or acute) (see also Ic) XV.f XV - Pathology
XV.f - Path: Diffuse alveolar damage (DAD-pattern) (see also IL) XV.ct XV - Pathology
XV.ct - Path: Delayed alveolar injury with delayed epithelialization (DAIDE) XVI.bb XVI - Imaging
XVI.bb - Imaging: Pneumomediastinum XIX.c XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA
XIX.c - BAL: An excess proportion of eosinophils
1
Valproate (Valproic acid)
I.a
I - Interstitial/parenchymal lung disease
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) V.b V - Pleural and/or pericardial involvement
V.b - Eosinophilic pleural effusion V.m V - Pleural and/or pericardial involvement
V.m - Pleuropericarditis - Pleuropericardial effusion (ANA unknown or negative) X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction XII.l XII - Cardiovascular involvement / toxicity
XII.l - Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP)
I.a - Pneumonitis (ILD), acute and/or severe (may cause ARDS) I.b I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) III.a III - Pulmonary/alveolar./airway hemorrhage/bleeding
III.a - Alveolar hemorrhage (AH), diffuse AH (DAH) V.a V - Pleural and/or pericardial involvement
V.a - Pleural effusion (uni- or bilateral) (can accompany DI-LDs) V.b V - Pleural and/or pericardial involvement
V.b - Eosinophilic pleural effusion V.m V - Pleural and/or pericardial involvement
V.m - Pleuropericarditis - Pleuropericardial effusion (ANA unknown or negative) X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction XII.l XII - Cardiovascular involvement / toxicity
XII.l - Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP)
2
Vancomycin
I.c
I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma IV.f IV - Airway involvement
IV.f - Severe or catastrophic bronchospasm or asthma attack (can be fatal) V.n V - Pleural and/or pericardial involvement
V.n - Hemopericardium - Bloody pericardial effusion X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.g X - Systemic/Distant conditions, syndromes and reactions
X.g - Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement) XII.m XII - Cardiovascular involvement / toxicity
XII.m - Cardiac- cardiorespiratory/pulmonary arrest XII.n XII - Cardiovascular involvement / toxicity
XII.n - Cardiovascular collapse - Cardiogenic shock - Hypotension
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) II.a II - Pulmonary edema - Acute lung injury - ARDS
II.a - Pulmonary edema, noncardiogenic (NCPE) IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma IV.f IV - Airway involvement
IV.f - Severe or catastrophic bronchospasm or asthma attack (can be fatal) V.n V - Pleural and/or pericardial involvement
V.n - Hemopericardium - Bloody pericardial effusion X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.g X - Systemic/Distant conditions, syndromes and reactions
X.g - Hypersensitivity reaction (may manifest with fever and/or skin, throat or airway involvement) XII.m XII - Cardiovascular involvement / toxicity
XII.m - Cardiac- cardiorespiratory/pulmonary arrest XII.n XII - Cardiovascular involvement / toxicity
XII.n - Cardiovascular collapse - Cardiogenic shock - Hypotension
1
Vemurafenib
I.b
I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component I.ad I - Interstitial/parenchymal lung disease
I.ad - Radiation recall pneumonitis X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.k X - Systemic/Distant conditions, syndromes and reactions
X.k - Sarcoid-like granulomatosis (endo-/extrathoracic) X.m X - Systemic/Distant conditions, syndromes and reactions
X.m - Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative) XII.ai XII - Cardiovascular involvement / toxicity
XII.ai - Cardiotoxicity XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib) XV.e XV - Pathology
XV.e - Path: ILD with a granulomatous component (see also Im)
I.b - Pneumonitis (ILD) I.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component I.ad I - Interstitial/parenchymal lung disease
I.ad - Radiation recall pneumonitis X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction X.f X - Systemic/Distant conditions, syndromes and reactions
X.f - Anaphylaxis-Anaphylactoid reaction (can be fatal) X.k X - Systemic/Distant conditions, syndromes and reactions
X.k - Sarcoid-like granulomatosis (endo-/extrathoracic) X.m X - Systemic/Distant conditions, syndromes and reactions
X.m - Vascultis (pulmonary, extrathoracic or systemic)-ANCA status unknown or negative) XII.ai XII - Cardiovascular involvement / toxicity
XII.ai - Cardiotoxicity XV.a XV - Pathology
XV.a - Path: NSIP-cellular pattern (see also Ia, Ib) XV.e XV - Pathology
XV.e - Path: ILD with a granulomatous component (see also Im)
1
Venlafaxine
I.b
I - Interstitial/parenchymal lung disease
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) I.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction XI.r XI - Miscellaneous
XI.r - Death following exposure or poisoning XII.f XII - Cardiovascular involvement / toxicity
XII.f - Cardiomyopathy (acute, subacute, chronic) XII.g XII - Cardiovascular involvement / toxicity
XII.g - Coronary artery disease (acute) - Myocardial ischemia/infarction XII.l XII - Cardiovascular involvement / toxicity
XII.l - Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP) XV.b XV - Pathology
XV.b - Path: Eosinophilic pneumonia (subacute or acute) (see also Ic)
I.b - Pneumonitis (ILD) I.c I - Interstitial/parenchymal lung disease
I.c - Eosinophilic pneumonia (pulmonary infiltrates and eosinophilia) I.e I - Interstitial/parenchymal lung disease
I.e - Acute eosinophilic pneumonia (AEP) I.m I - Interstitial/parenchymal lung disease
I.m - ILD with a granulomatous component IV.a IV - Airway involvement
IV.a - Bronchospasm - Wheezing - Asthma X.a X - Systemic/Distant conditions, syndromes and reactions
X.a - DRES syndrome - DRESS-like reaction XI.r XI - Miscellaneous
XI.r - Death following exposure or poisoning XII.f XII - Cardiovascular involvement / toxicity
XII.f - Cardiomyopathy (acute, subacute, chronic) XII.g XII - Cardiovascular involvement / toxicity
XII.g - Coronary artery disease (acute) - Myocardial ischemia/infarction XII.l XII - Cardiovascular involvement / toxicity
XII.l - Cardiac arrhythmias or dysrhythmias (AF, VT, VF, TdP) XV.b XV - Pathology
XV.b - Path: Eosinophilic pneumonia (subacute or acute) (see also Ic)
1