背景:伴嗜酸性粒细胞增多和全身症状(DRESS)综合征的药物反应是一种严重的,对经常涉及终末器官损伤的罪魁祸首药物的危及生命的反应。皮质类固醇是DRESS综合征的一线治疗方法;然而,某些患者人群可能禁用皮质类固醇。目前文献中报道的仅有54例详述使用环孢素治疗DRESS综合征的病例。
目的:本系列病例的目的是通过汇总症状缓解时间,在大型患者队列中检查环孢素对DRESS综合征的治疗。复发率,以及治疗剂量和持续时间。
方法:本研究为回顾性队列研究。包括2015年至2019年由董事会认证的皮肤科医生诊断为DRESS综合征并在科罗拉多大学医院接受治疗的患者。
结果:19例DRESS综合征符合我们的纳入标准。短期服用环孢菌素,我们队列中的19例患者中有17例(89%)症状缓解(平均治疗时间为5.26天)。使用环孢素治疗后DRESS综合征的复发发生在19例队列中的3例(16%)。
结论:我们的研究支持使用环孢素治疗DRESS综合征,特别是在无法维持长期免疫抑制的患者中。在更大的研究人群中,需要进一步的研究来比较环孢素与当前治疗标准的疗效,并调查长期结果。
BACKGROUND: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, life-threatening reaction to a culprit drug that frequently involves end-organ damage. Corticosteroids are the first-line treatment for DRESS syndrome; however, corticosteroids may be contraindicated in certain patient populations. There are currently only 54 cases detailing the use of cyclosporine for the treatment of DRESS syndrome reported in the literature.
OBJECTIVE: The aim of this case series was to examine the treatment of DRESS syndrome with cyclosporine in a large patient cohort by aggregating time to symptom resolution, recurrence rate, and treatment dose and duration.
METHODS: This
study was a retrospective cohort
study. Patients diagnosed with DRESS syndrome by a board-certified dermatologist and treated at the University of Colorado Hospital from 2015 to 2019 were included.
RESULTS: Our inclusion criterion was met by 19 occurrences of DRESS syndrome. With a short course of cyclosporine, 17 of 19 patients in our cohort (89%) had resolution of symptoms (mean treatment length of 5.26 days). DRESS syndrome\'s relapse after treatment with cyclosporine occurred in 3 of 19 (16%) occurrences of the cohort.
CONCLUSIONS: Our
study supports the use of cyclosporine in the treatment of DRESS syndrome, particularly in patients who are unable to sustain prolonged immunosuppression. Further research is necessary to compare the efficacy of cyclosporine to the current standard of care in a larger
study population and investigate long-term outcomes.