New Wrinkle in DRESS Pathogenesis

Drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug-induced hypersensitivity syndrome, is a serious drug-induced reaction involving the skin, liver, lungs, kidneys, and heart. Patients can also have lymphadenopathy, lymphocytosis, and monocytosis. The disease is associated with considerable morbidity and a mortality rate of more than 10%. Anticonvulsants, allopurinol, sulfa drugs, and minocycline are the most frequent causative agents. The pathogenesis is unknown, but activation of T cells and viral reactivation, particularly of herpesvirus, have been implicated. To examine the role of these factors, investigators prospectively evaluated 40 patients with DRESS induced by carbamazepine, allopurinol, or sulfameth…