Table 1.
Demographic and Clinical Features of Patients With DRESS Syndrome During Raltegravir Treatment
| Features | Patient [Reference] | |||||
|---|---|---|---|---|---|---|
| 1 [Current] | 2 [6] | 3 [7] | 4 [8] | 5 [9] | 6 [10] | |
| Age, y | 44 | 64 | 46 | 55 | 39 | 18 |
| Sex | Male | Female | Female | Female | Male | Female |
| Ethnicity (birthplace) | African (Zambia) | African (USa) | African (Congo) | African (UKa) | African (Ivory Coast) | Hispanic (Mexico) |
| Therapy at onset of DRESS syndrome (treatment duration, wk) |
Raltegravir (4), darunavir (4), ritonavir (4), zidovudine (4), lamivudine (4) | Raltegravir (6), darunavir (6), ritonavir (6) | Raltegravir (8), lopinavir (>20), ritonavir (>20), tenofovir (>20) | Raltegravir (4), tenofovir (>20), emtricitabine (>20), sulfamethoxazole (4), trimethoprim (4), codeine (4) | Raltegravir (4), darunavir (>20), ritonavir (>20), atovaquone (4) |
Raltegravir (5), lopinavir (>20), ritonavir (>20), zidovudine (>20), lamivudine (>20) |
| Subsequent therapy during resolution of DRESS syndrome |
Dolutegravir, atazanavir, zidovudine, lamivudine |
NK | Lopinavir, ritonavir, tenofovir |
“A protease inhibitor,” tenofovir, emtricitabine |
Darunavir, ritonavir, abacavir, lamivudine |
Lopinavir, ritonavir, tenofovir, emtricitabine |
| Main clinical features of DRESS syndrome | Generalized rash, malaise, diarrhea, no fever | Generalized rash, facial edema, lymphadenopathy, no fever | Generalized rash, abdominal pain, lymphadenopathy, fever | Generalized rash, malaise, fever | Rash, oral ulcers, fever | Generalized rash, edema of face hands and feet, lymphadenopathy, fever |
| Peak creatinine, µmol/L | 149 | NK | 2× ULN | NK | NK | NK |
| ALT, U/L | 295 | 520 | Normal | 65 | 617 | 147 |
| Eosinophil count, ×109/L | 1.9 | 2.2 | Normal | 1.5 | 1.3 | 1.3 |
| Outcome | Resolved | Resolved | Resolved | Resolved | Resolved | Resolved |
| RegiSCAR score | 4 (probable) | 3 (possible) | 5 (probable) | 5 (probable) | 2 (possible) | 8 (definite) |
| Naranjo score | 4 (possible) | 4 (possible) | 7 (probable) | 3 (possible) | 4 (possible) | 7 (probable) |
Abbreviations: ALT, alanine aminotransferase; DRESS, drug reaction with eosinophilia and systemic symptoms; NK, not known; UK, United Kingdom; ULN, upper limit of normal; US, United States.
a
Presumed birthplace.