. 2016 Dec 31:519–576. doi: 10.1007/978-3-319-33919-1_26

Chart 26.4.

Diagnostic criteria for DRESS/DIHS proposed by Japanese group

1. Maculopapular rash developing >3 weeks after starting therapy with a limited number of drugs

2. Persistent clinical findings after drug withdrawal

3. Fever (>38 °C)

4. Hepatic abnormalities (glutamic pyruvic transaminase >100 U/l)^a

5. Leukocyte abnormalities (at least one present)

(a) Leukocytosis (>11,000/mm³)

(b) Atypical lymphocytosis (>5%)

6. HHV-6 reactivation^b

The diagnosis is confirmed by the presence of the seven criteria (typical DIHS) or of the first five criteria (atypical DIHS)

^aThis can be replaced by other organ involvement such as renal involvement

^bReactivation is detected from the second to third week after symptom onset, through IgG anti-HHV-6 titer elevation