Antiviral Induced Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Dyndrome: A Literature Review

Abstract

Drug reaction with eosinophilia and systemic symptoms syndrome (DRESS) is a delayed infrequent potentially life-threatening drug reaction. Fever, rash, lymphadenopathy, eosinophilia, and hepatic involvement are common features. Aromatic anticonvulsants and allopurinol are the most frequent causative agents. However, some cases of antivirals induced DRESS are available. In this review, we try to summarize studies of antiviral induced DRESS syndrome.  The data were collected by searching PubMed, Science Direct, Google Scholar, Scopus, Cochrane database systematic reviews, and Islamic World Science Citation Center (ISC). The Keywords used as search terms were “DRESS syndrome”, “drug-induced hypersensitivity reaction (DIHS)”, “antiviral”, and names of various antiviral agents. Finally, a total of 28 relevant articles up to the date of publication were included for review. Totally, 30 cases of antiviral induced DRESS are reported. European registry on severe cutaneous adverse drug reactions (RegiSCAR) was the usual used clinical diagnostic criteria. Most of the reports were related to, telaprevir. Rash and fever actually occurred in a large number of these patients. Eosinophilia was the most reported hematologic involvement. Liver injury is the most defined type of organ damage. Most of the patients managed with systemic corticosteroids. The death occurred in 1 patient from liver decompensation. The reactivation various viruses especially HHV-6 is reported in 2 Cases. The latency period was between 10 and 330 days after drug administration. It is necessary to perform more studies, especially those focused on the association between DRESS syndrome and viral reactivation and also its effective management.

J Pharm Care 2020; 8(1): 35-47.