Glucocorticoids for Treatment of Severe Pediatric Drug Hypersensitivity Syndrome

Abstract

Drug hypersensitivity syndrome (DHS) is a potentially life-threatening form of drug reaction that is particularly associated with anticonvulsants. The role of glucocorticoids (GC) for treatment of this condition is controversial. We describe a child with DHS including severe cutaneous and hepatic involvement, which improved during GC treatment, flared when GC were inadvertently withdrawn, and resolved once they were again given. Our experience suggests GC may be of benefit to children with severe DHS. (Pediatr Asthma Allergy Immunol 2005; 18[3]:156-160.)

DRESS Syndrome: A Practical Approach for Primary Care Practitioners

“…Withdrawal of steroid treatment may result in rapid return of the symptoms and resolution once they are given again. 9 They have been proven to be most helpful in patients with severe systemic involvement. Intravenous immunoglobulin (1 mg/kg/day for 2 days) has shown to be beneficial in a 6-year-old boy with phenytoin-induced DRESS.…”

“…8 Studies have shown up to 80% cross-reactivity between them. 9 Other medications that can cause DRESS include lamotrigine, gabapentine, nonsteroidal anti-inflammatory drugs, captopril, mood stabilizers, and antiretroviral medications. 7 A temporal relationship between medicine use and the onset of the syndrome is the most important indicator of causality.…”