Corticosteroids show promise in paediatric drug reaction with eosinophilia, systemic symptoms

Use of corticosteroids appears to be an effective treatment for paediatric drug reaction with eosinophilia and systemic symptoms (DRESS), suggest the results of a recent study. In severe cases, corticosteroids used in conjunction with intravenous immunoglobulin result in fast clinical improvement.

“Pediatric DRESS commonly involves the liver. With treatment, the prognosis is commonly good, but serious complications may occur,” the investigators said.

A systematic literature review was carried out to examine available data on DRESS in the paediatric population (aged <18 years). Eighty-two articles with a total of 148 patients met the inclusion criteria.

Of the patients, 97.9 percent had a skin rash. In addition, the liver was the second most common organ involved (84.5 percent). Among those (n=143) who received any treatment regimen, 85.3 percent were treated with systemic steroids.

Five patients who were initially misdiagnosed and were treated with intravenous immunoglobulin alone did not show improvement in symptoms, while those treated with steroids and intravenous immunoglobulin (2.7 percent) displayed rapid clinical improvement.

A low mortality rate was recorded (3.0 percent). Complications included multiorgan failure and acute respiratory distress syndrome.

This study was limited by the absence of a statistical analysis due to limited availability of data.

“DRESS is a drug-induced hypersensitivity reaction that can have fatal complications,” according to the investigators.