scholarly journals Increased ratio of FoxP3+ regulatory T cells/CD3+ T cells in skin lesions in drug-induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms

2014 ◽  
Vol 39 (3) ◽  
pp. 284-291 ◽  
Author(s):  
H. Morito ◽  
K. Ogawa ◽  
T. Fukumoto ◽  
N. Kobayashi ◽  
T. Morii ◽  
...  
Keyword(s):  
T Cells ◽  
Regulatory T Cells ◽  
Hypersensitivity Syndrome ◽  
Skin Lesions ◽  
Drug Induced ◽  
Drug Rash ◽  
Systemic Symptoms

scholarly journals Lamotrigine Associated DRESS Syndrome – a Case Report

2015 ◽  
Vol 7 (1) ◽  
pp. 23-33 ◽  
Author(s):  
Jagoda Balaban ◽  
Đuka Ninković-Baroš
Keyword(s):  
Case Report ◽  
Female Patient ◽  
Skin Rash ◽  
Respiratory Symptoms ◽  
Hypersensitivity Syndrome ◽  
Organ Involvement ◽  
Dress Syndrome ◽  
Drug Induced ◽  
Drug Rash ◽  
Systemic Symptoms

AbstractDrug-induced delayed multiorgan hypersensitivity syndrome, also known as drug rash (reaction) with eosinophilia and systemic symptoms (DRESS) syndrome, represents a drug-induced cluster of skin, hematologic and systemic symptoms. More than forty drugs have been associated with this syndrome. We present a case of DRESS syndrome suspecting that lamotrigine was directly responsible for the patient’s rash and other symptoms. A female patient presented with extensive skin rash, fever, hematologic abnormalities, organ involvement such as hepatitis, pancreatitis and respiratory symptoms. The symptoms developed four weeks after the initiation of the offending drug, and disappeared eight weeks after its discontinuation.

scholarly journals Current Perspective Regarding the Immunopathogenesis of Drug-Induced Hypersensitivity Syndrome/Drug Reaction with Eosinophilia and Systemic Symptoms (DIHS/DRESS)

2021 ◽  
Vol 22 (4) ◽  
pp. 2147
Author(s):  
Fumi Miyagawa ◽  
Hideo Asada
Keyword(s):  
T Cells ◽  
Drug Reaction ◽  
Immune Responses ◽  
Cd8 T Cells ◽  
Prolonged Exposure ◽  
Human Herpesvirus ◽  
Subsequent Development ◽  
Hypersensitivity Syndrome ◽  
Drug Induced ◽  
Systemic Symptoms

Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS) is a severe type of adverse drug eruption associated with multiorgan involvement and the reactivation of human herpesvirus 6, which arises after prolonged exposure to certain drugs. Typically, two waves of disease activity occur during the course of DIHS/DRESS; however, some patients experience multiple waves of exacerbation and remission of the disease. Severe complications, some of which are related to cytomegalovirus reactivation, can be fatal. DIHS/DRESS is distinct from other drug reactions, as it involves herpes virus reactivation and can lead to the subsequent development of autoimmune diseases. The association between herpesviruses and DIHS/DRESS is now well established, and DIHS/DRESS is considered to arise as a result of complex interactions between several herpesviruses and comprehensive immune responses, including drug-specific immune responses and antiviral immune responses, each of which may be mediated by distinct types of immune cells. It appears that both CD4 and CD8 T cells are involved in the pathogenesis of DIHS/DRESS but play distinct roles. CD4 T cells mainly initiate drug allergies in response to drug antigens, and then herpesvirus-specific CD8 T cells that target virus-infected cells emerge, resulting in tissue damage. Regulatory T-cell dynamics are also suggested to contribute to the diverse symptoms of DIHS/DRESS. However, the pathomechanisms of this complex disease remain largely unknown. In particular, how viral infections contribute to the pathogenesis of DIHS/DRESS and why autoimmune sequelae arise in DIHS/DRESS are yet to be elucidated. This review describes the clinical features of DIHS/DRESS, including the associated complications and sequelae, and discusses recent advances in our understanding of the immunopathogenic mechanisms of DIHS/DRESS.

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