Although medications are designed to relieve symptoms, treat diseases, and improve our quality of life, they can sometimes trigger adverse reactions that compromise our health. These unexpected reactions, although rare, can be serious and require immediate medical attention. In this article, we will discuss DRESS syndrome, an adverse reaction to medications, along with its symptoms, causes, and treatment.
What is DRESS syndrome and what causes it?
DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is a rare, severe allergic reaction caused by the use of certain medications. This condition can affect vital organs such as the skin, liver, kidneys, lungs and heart. Unlike other allergic reactions, symptoms do not appear immediately, but usually appear between two and six weeks after starting treatment with the triggering drug, which makes early diagnosis difficult.
The cause of DRESS syndrome is complex and multifactorial. Among the main factors involved are exposure to certain drugs, genetic predispositions, reactivation of latent viruses and abnormal immune responses. This combination of elements contributes to the development of the syndrome being difficult to predict and manage in its early stages.
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View pathologies and treatmentsDue to its systemic impact, DRESS syndrome can lead to serious consequencesIts mortality rate is close to 10 %, with acute liver failure being one of the most frequent and severe complications.
Difference between DRESS and Stevens-Johnson syndrome
DRESS syndrome and Stevens-Johnson syndrome are severe drug reactions that are distinguished by their clinical features and course. DRESS syndrome is characterized by a late onset, with symptoms that progress gradually. In addition to cutaneous manifestations, it affects multiple internal organs, and often includes fever, eosinophilia, atypical lymphocytes and liver or kidney dysfunction.
Stevens-Johnson syndrome, on the other hand, is a more acute reaction, characterized by a rapid onset. Its symptoms are concentrated mainly in the skin and mucous membranes, presenting with painful blisters, erythema and epidermal detachment.
Distinguishing between the two syndromes is essential to implement appropriate treatment early and prevent potentially fatal complications.
Symptoms of drug-induced hypersensitivity syndrome
One of the greatest challenges of drug-induced hypersensitivity syndrome is its late presentation. Symptoms usually appear between 2 and 6 weeks after exposure to the drug., with a gradual and variable evolution that makes early diagnosis difficult. The most common symptoms include:
- Skin rash: It is usually extensive, with papules and macules that may develop into peeling.
- Persistent fever: It is one of the first signs and can exceed 38ºC.
- Hematological disorders: include eosinophilia, atypical lymphocytes, and, in some cases, leukocytosis.
- Internal organ involvement: the most affected are usually the liver, kidneys, lungs and heart.
The progressive appearance of symptoms can make diagnosis difficult, increasing the risk of complications if action is not taken quickly.
How Dress syndrome is detected
Early diagnosis of DRESS syndrome is crucial to prevent complications. The diagnostic process is based on clinical evaluation along with laboratory tests and complementary studies. The criteria used for its diagnosis include:
- Presence of skin rash.
- Persistent high fever.
- Hematological alterations, such as eosinophilia or atypical lymphocytes.
- Dysfunction of one or more internal organs.
Additional studies may include liver and kidney function tests, chest X-rays or skin biopsies to confirm the diagnosis and rule out other conditions.
Treatment of DRESS syndrome
Treatment for DRESS syndrome begins with immediate discontinuation of the offending medication, as it may prolong recovery and increase the risk of serious complications.
In mild cases, skin lesions can be improved with topical antihistamines and corticosteroids, which help to relieve symptoms in a localized manner. However, when the syndrome affects internal organs or presents severe symptoms, it is necessary to resort to systemic corticosteroids to control widespread inflammation and prevent permanent damage to vital organs such as the kidneys or heart.
Management should be supervised by a specialized medical team to ensure proper treatment minimizes possible complications.
Does drug-induced hypersensitivity syndrome require hospitalization?
In many cases, DRESS syndrome requires hospitalization., especially if organs such as the liver, kidneys, lungs or heart are involved. Patients with more severe symptoms may require intensive care for constant monitoring and administration of necessary medications.
Recovery after Dress syndrome
Recovery from DRESS syndrome can vary depending on the severity of the case and how quickly treatment has been started. Generally, The recovery period can last between 6 and 9 weeks., although in some more severe cases, the disease can last for several months, with possible relapses.
It is essential that patients strictly follow the prescribed treatment and undergo the recommended medical check-ups to ensure a full recovery and minimize the risk of complications.
At Clínica Elgeadi, we have a team of highly trained professionals to offer accurate diagnoses and timely treatments, even in complex cases such as DRESS syndrome. We offer comprehensive care of excellence, guaranteeing the well-being and health of each patient. Do not hesitate to trust Clínica Elgeadi to receive the best possible medical care.
2 thoughts on “Síndrome de DRESS: causas, síntomas y tratamiento para la hipersensibilidad inducida por fármacos”
Hello good morning
My sister has a very similar reaction to these symptoms, except she develops red spots, facial swelling, and a fever almost immediately when she takes medication. She went to the emergency room, and they don't know what it is, so they don't know what to give her because they give her allergy medications, and they also make her feel sick. It's happened to her with paracetamol, ibuprofen, and chlorphenamine, which they've given her. She doesn't know what to do; she's very worried, and when she gets a cold, she can't even take anything to reduce her fever.
Hello Jasmine,
Thank you for your comment. We are deeply sorry for the situation your sister is going through. Based on what you describe, it could be a complex adverse reaction to medications, but a detailed evaluation would be necessary to arrive at an accurate diagnosis and assess the safest treatment options. If you wish, you can schedule an appointment with our team by calling 91 005 39 00 for a more comprehensive evaluation. We are at your disposal.
Greetings.