Does sensitization by SARS-CoV-2 immune complexes trigger DRESS syndrome?

Cruz, Virgínia Barbeitos; Júnior, Luiz Fernando Fróes Fleury; Kobal, Christiane Reis; Silva, Nílzio Antônio da

doi:10.1016/j.bjid.2022.102337

Cited by 4 publications

(1 citation statement)

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“…These patients are particularly prone to classical risk factors for DIHS/DRESS, as they are frequently affected by multiple comorbidities and exposed to several drugs potentially associated with this syndrome. Few isolated cases of DIHS/DRESS in patients with COVID-19 have been described in the literature [ 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 ], but the actual incidence of this condition in patients with SARS-CoV-2 pneumonia is still to be fully explored. In a retrospective cohort analysing 9330 patients hospitalised with COVID-19 from a US healthcare system [ 99 ] between January 2020 and May 2021, six cases of DRESS syndrome were identified, corresponding to an incidence of 6.43 per 10,000 patients.…”

Section: Aetiology and Pathogenesismentioning

confidence: 99%

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): Focus on the Pathophysiological and Diagnostic Role of Viruses

et al. 2023

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Drug reaction with eosinophilia and systemic symptoms (DRESS) is a heterogeneous, multiorgan and potentially life-threatening drug-hypersensitivity reaction (DHR) that occurs several days or weeks after drug initiation or discontinuation. DHRs constitute an emerging issue for public health, due to population aging, growing multi-organ morbidity, and subsequent enhanced drug prescriptions. DRESS has more consistently been associated with anticonvulsants, allopurinol and antibiotics, such as sulphonamides and vancomycin, although new drugs are increasingly reported as culprit agents. Reactivation of latent infectious agents such as viruses (especially Herpesviridae) plays a key role in prompting and sustaining aberrant T-cell and eosinophil responses to drugs and pathogens, ultimately causing organ damage. However, the boundaries of the impact of viral agents in the pathophysiology of DRESS are still ill-defined. Along with growing awareness of the multifaceted aspects of immune perturbation caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing SARS-CoV-2-related disease (COVID-19) pandemic, novel interest has been sparked towards DRESS and the potential interactions among antiviral and anti-drug inflammatory responses. In this review, we summarised the most recent evidence on pathophysiological mechanisms, diagnostic approaches, and clinical management of DRESS with the aim of increasing awareness on this syndrome and possibly suggesting clues for future research in this field.

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