Background

The prognosis of drug-induced hypersensitivity syndrome (DiHS)/drug reaction with eosinophilia and systemic symptoms (DRESS) is highly unpredictable. Severe complications, either related or unrelated to cytomegalovirus (CMV) reactivation, are a highly probable cause of death.

Objectives

The aim was to establish a scoring system for DiHS/DRESS that can be used to monitor severity, predict prognosis, and stratify the risk of developing CMV disease and complications.

Methods

A retrospective analysis of 55 patients with DiHS/DRESS was performed. A composite score was created using clinical data. DiHS/DRESS patients were also stratified into 3 groups based on the scores to predict the risk of CMV reactivation and complications.

Results

This scoring system made it possible to predict CMV disease and complications. Scores ≥4 were associated with the later development of CMV disease and complications, while no patients with scores <4 developed complications.

Limitations

This was a single-institution study with a relatively small patient cohort that lacked a validation cohort.

Conclusions

Our scoring system may be useful for predicting CMV-related complications, and early intervention with anti-CMV agents should be considered in patients with scores ≥4 or with evidence of CMV reactivation.

中文翻译：

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药物引起的过敏反应综合征/药物反应伴嗜酸性粒细胞增多和全身症状严重程度评分：评估疾病严重程度和预测致命巨细胞病毒病的有用工具

背景

药物诱发的超敏综合征（DiHS）/药物反应伴嗜酸性粒细胞增多和全身症状（DRESS）的预后是高度不可预测的。与巨细胞病毒（CMV）激活相关或无关的严重并发症是高度可能的死亡原因。

目标

目的是建立DiHS / DRESS评分系统，该系统可用于监测严重程度，预测预后以及对发生CMV疾病和并发症的风险进行分层。

方法

对55例DiHS / DRESS患者进行了回顾性分析。使用临床数据创建综合评分。DiHS / DRESS患者也根据评分分为3组，以预测CMV激活和并发症的风险。

结果

该评分系统使预测CMV疾病和并发症成为可能。得分≥4与CMV疾病的发展和并发症有关，而得分<4的患者则没有并发症。

局限性

这是一项单机构研究，患者队列相对较小，但没有验证队列。

结论

我们的评分系统可能有助于预测与CMV相关的并发症，并且对于得分≥4或有CMV复活迹象的患者，应考虑使用抗CMV药物进行早期干预。