Background

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a drug-induced hypersensitivity reaction that can have fatal complications. Although substantial data exist regarding DRESS in adults, to our knowledge, a systematic review of available literature has not been performed in children.

Objective

To review available data on DRESS in the pediatric population.

Methods

A systematic literature review was performed for pediatric (aged <18 years) patients with DRESS.

Results

We included 82 articles with 148 patients; of these, 97.9% experienced a skin rash, and the liver was the second most common organ involved (84.5%). Among 143 patients for which a treatment regimen was reported, 85.3% were treated with systemic steroids. Intravenous immunoglobulin alone failed to improve symptoms in 5 patients who were initially misdiagnosed, whereas those treated with intravenous immunoglobulin and steroids (2.7%) showed rapid clinical improvement. The mortality rate was low (3.0%). Complications included multiorgan failure and acute respiratory distress syndrome.

Limitations

Limitations included limited availability of data for statistical analysis.

Conclusion

Pediatric DRESS commonly involves the liver. With treatment, the prognosis is commonly good, but serious complications may occur. Corticosteroids, possibly in conjunction with intravenous immunoglobulin in severe cases, may serve as an effective, valuable treatment of pediatric DRESS.

中文翻译：

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小儿人群中嗜酸性粒细胞增多和全身症状（DRESS）的药物反应：文献的系统评价。

背景

嗜酸性粒细胞增多和全身症状（DRESS）的药物反应是药物引起的超敏反应，可能导致致命的并发症。尽管存在关于成人DRESS的大量数据，但据我们所知，尚未对儿童进行现有文献的系统评价。

目的

审查有关儿科患者DRESS的可用数据。

方法

对儿科（<18岁）DRESS患者进行了系统的文献综述。

结果

我们纳入了148例患者的82篇文章；其中97.9％的人出现皮疹，肝脏是第二常见的器官（84.5％）。在143例据报有治疗方案的患者中，有85.3％的患者接受了全身性激素治疗。最初被误诊的5例患者单独使用静脉免疫球蛋白未能改善症状，而静脉注射免疫球蛋白和类固醇治疗的患者（2.7％）表现出快速的临床改善。死亡率低（3.0％）。并发症包括多器官功能衰竭和急性呼吸窘迫综合征。

局限性

局限性包括统计分析数据的可用性有限。

结论

小儿DRESS通常累及肝脏。通过治疗，通常预后良好，但可能发生严重的并发症。在严重的情况下，皮质类固醇可能与静脉注射免疫球蛋白联用，可作为一种有效的，有价值的小儿DRESS治疗药物。