DRESS syndrome laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D., Serge Korjian M.D.
Overview
Laboratory findings of patients with DRESS syndrome usually differ depending on the organ involvement. Common Lab findings include anemia, eosinophilia, atypical lymphocytosis, monocytosis, and thrombocytopenia
Laboratory Findings
The following laboratory tests are usually performed to identify DRESS syndrome and associated complications:
- Complete blood count
- Liver function tests (ALT, AST, GGT, ALP, bilirubin)
- Serum creatinine
- TSH (may be considered at diagnosis and after 2-3 months due to high incidence of thyroiditis)
- Anti-EBV and anti-CMV IgM and IgG antibodies
- Serum and urine drug concentrations
- Urinalysis (typically remarkable for proteinuria in renal involvement)
Laboratory findings of patients with DRESS syndrome usually differ depending on the organ involvement. The reported incidence of organ involvement has been highly variable in described cases. The following table illustrates the incidence of organ involvement in DRESS syndrome:[1][2][3]
| Incidence of organ involvement in DRESS syndrome | |
|---|---|
| Organ | Percent of patients with involvement |
| Liver | 60% - 90% |
| Kidney | 40% - 50% |
| Pulmonary | 30% - 40% |
| Cardiac/muscular | 15% -20% |
| Pancreas | 5% - 10% |
| Lung | 5% - 10% |
The following table illustrates the incidence of common lab abnormalities associated with DRESS syndrome:[1][2][3]
| Incidence of hematologic abnormalities in DRESS syndrome | |
|---|---|
| Abnormality | Percent of patients with abnormality |
| Atypical lymphocytes | 60% - 70% |
| Eosinophilia | 50% - 70% |
| Anemia | 50% - 60% |
| Monocytosis | 40% - 50% |
| Lymphocytopenia | 40% - 50% |
| Thrombocytopenia | 25% - 50% |
| Lymphocytosis | 25% - 50% |
References
- ↑ 1.0 1.1 Avancini J, Maragno L, Santi CG, Criado PR (2015). "Drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome: clinical features of 27 patients". Clin Exp Dermatol. doi:10.1111/ced.12682. PMID 26271788.
- ↑ 2.0 2.1 Chen YC, Chiu HC, Chu CY (2010). "Drug reaction with eosinophilia and systemic symptoms: a retrospective study of 60 cases". Arch Dermatol. 146 (12): 1373–9. doi:10.1001/archdermatol.2010.198. PMID 20713773.
- ↑ 3.0 3.1 Cacoub P, Musette P, Descamps V, Meyer O, Speirs C, Finzi L; et al. (2011). "The DRESS syndrome: a literature review". Am J Med. 124 (7): 588–97. doi:10.1016/j.amjmed.2011.01.017. PMID 21592453.