Adverse Reactions & Pharmacovigilance

DRESS Syndrome DRESS

TRDRESS Sendromu
Also known as:Drug reaction with eosinophilia and systemic symptoms · Drug-induced hypersensitivity syndrome · DIHS

A severe, delayed, T-cell-mediated drug hypersensitivity syndrome with fever, extensive rash, lymphadenopathy, haematological abnormalities such as eosinophilia, and internal organ involvement.

In depth

DRESS (drug reaction with eosinophilia and systemic symptoms), also called drug-induced hypersensitivity syndrome (DIHS), typically begins 2–8 weeks after the drug is started. Facial oedema is characteristic, atypical lymphocytes are common, and the liver is the organ most often involved, followed by the kidneys, lungs and heart. Reactivation of human herpesvirus 6 and other herpesviruses is frequently detected, and the RegiSCAR score grades diagnostic certainty.

Common culprits are aromatic anticonvulsants (carbamazepine, phenytoin, phenobarbital, lamotrigine), allopurinol, sulfonamides such as sulfasalazine, dapsone, minocycline and vancomycin. The course may be prolonged, with flares after drug withdrawal and late autoimmune sequelae such as thyroiditis; systemic glucocorticoids, tapered slowly, are widely used for significant organ involvement.

Clinical pearl

Because of the long latency, the culprit is often a drug started several weeks earlier rather than the most recent addition; liver tests, renal function and eosinophil count should be checked early.

Example drugs

Carbamazepine Phenytoin Allopurinol Lamotrigine Minocycline Vancomycin
TRIn Turkish

DRESS Sendromu

Ateş, yaygın döküntü, lenfadenopati, eozinofili gibi hematolojik anormallikler ve iç organ tutulumuyla seyreden, gecikmiş başlangıçlı, T hücre aracılı ağır ilaç aşırı duyarlılık sendromudur.

DRESS (eozinofili ve sistemik semptomlarla seyreden ilaç reaksiyonu), ilaca bağlı aşırı duyarlılık sendromu (DIHS) olarak da adlandırılır ve genellikle ilaca başlandıktan 2–8 hafta sonra ortaya çıkar. Yüz ödemi karakteristiktir, atipik lenfositler sıktır; en sık tutulan organ karaciğerdir, bunu böbrekler, akciğerler ve kalp izler. İnsan herpesvirüsü 6 ve diğer herpesvirüslerin reaktivasyonu sıklıkla saptanır; tanısal kesinlik RegiSCAR skoruyla derecelendirilir.

Sık sorumlu ilaçlar aromatik antikonvülzanlar (karbamazepin, fenitoin, fenobarbital, lamotrijin), allopurinol, sülfasalazin gibi sülfonamidler, dapson, minosiklin ve vankomisindir. Seyir uzun olabilir; ilaç kesildikten sonra alevlenmeler ve tiroidit gibi geç otoimmün sekeller görülebilir. Belirgin organ tutulumunda, yavaş azaltılarak kesilen sistemik glukokortikoidler yaygın olarak kullanılır.

Latent dönem uzun olduğundan sorumlu ilaç çoğu zaman en son eklenen değil, birkaç hafta önce başlanmış bir ilaçtır; karaciğer testleri, böbrek fonksiyonu ve eozinofil sayısı erken dönemde kontrol edilmelidir.

Diğer adları:Eozinofili ve sistemik semptomlarla seyreden ilaç reaksiyonu · İlaca bağlı aşırı duyarlılık sendromu
Updated 24.09.2026 0 views Educational reference — verify against current sources before clinical use.

Read next

Stevens–Johnson SyndromeStevens–Johnson Sendromu

A rare, severe, usually drug-induced mucocutaneous reaction with widespread keratinocyte death, blistering and mucosal erosions, in which epidermal detachment involves less than 10% of body surface area.

 Drug Hypersensitivityİlaç Aşırı Duyarlılığı

An adverse drug reaction that clinically resembles allergy; when a specific immunological mechanism (IgE or T cells) is demonstrated it is termed drug allergy, otherwise non-allergic hypersensitivity.

 Type B Adverse ReactionTip B Advers Reaksiyon

An adverse drug reaction that is not expected from the drug's known pharmacology, is largely independent of dose, and is uncommon but frequently serious.

 HepatotoxicityHepatotoksisite

Liver injury caused by a drug, herbal or dietary supplement or other chemical, ranging from asymptomatic aminotransferase elevation to cholestasis, hepatitis and acute liver failure.

 Cross-ReactivityÇapraz Reaktivite

The occurrence of a hypersensitivity reaction to a drug in a patient sensitised to a different drug, because both share a structural determinant or trigger the same reaction pathway.

 TaperingAzaltarak Kesme

The gradual, planned reduction of a drug's dose over time before stopping it, to avoid withdrawal symptoms, rebound, disease flare or insufficient endogenous hormone production.