CLINICAL DIAGNOSIS AND MANAGEMENT OF DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS(DRESS) IN CHILDREN: AN EAACI POSITION PAPER

Le résumé fourni par la source

Drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug-induced hypersensitivity syndrome (DIHS), is a rare but severe cutaneous adverse drug reaction (SCAR) which presents by both skin and systemic symptoms and a significant mortality rate. The clinical features and prognosis in children differ markedly from those in adults. The diagnosis of DRESS is based on several clinical and laboratory criteria, which have been developed for adult patients but have not been validated for children. Differential diagnosis is both important and challenging in children due to the potential mimicry of a wide range of diseases, particularly viral infections. Causality assessment tools, in vivo skin tests, and in vitro tests have been used to identify the culprit drugs in DRESS, with low to moderate sensitivity in adults. However, these tools are more rarely employed or reported in children. Adult guidelines or consensus reports recommend a severity-based, stepwise treatment approach for DRESS, whereas no such severity classification or treatment algorithms exist for children, leading to inconsistent management with numerous instances of overtreatment and undertreatment. This EAACI Task Force on paediatric SCARs has developed a severity classification and a treatment strategy based on this classification, along with recommendations for the diagnosis and treatment of DRESS in children.

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