DRESS syndrome diagnostic criteria
The symptoms of DRESS syndrome usually begin several weeks after exposure to the offending drug. There is no gold standard for diagnosis, and at least two diagnostic criteria have been proposed. The RegiSCAR criteria [1] and the Japanese consensus group criteria[2] are detailed in the table below.
| RegiSCAR inclusion criteria for DRESS syndrome. Three of the four starred criteria required for diagnosis | Japanese consensus group diagnostic criteria for DIHS. Seven criteria needed for diagnosis of DIHS or the first five criteria required for diagnosis of atypical DIHS |
|---|---|
| Hospitalization | Maculopapular rash developing > 3 weeks after starting the suspected drug |
| Reaction suspected to be drug-related | Prolonged clinical symptoms 2 weeks after discontinuation of the suspected drug |
| Acute Rash* | Fever > 38 °C |
| Fever > 38 °C* | Liver abnormalities (ALT > 100 U/L) or other organ involvement |
| Lymphadenopathy in at least two sites* | Leukocyte abnormalities |
| Involvement of at least one internal organ* | Leukocytosis ( > 11 x 109/L) |
| Blood count abnormalities (lymphopenia or lymphocytosis*, eosinophilia*, thrombocytopenia*) | Atypical lymphocytosis (>5%) |
| Lymphadenopathy | |
| Human herpesvirus 6 reactivation |
- ↑ Kardaun SH, Sidoroff A, Valeyrie-Allanore L, et al. (2007). "Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist?". Response Br J Dermatol. 156 (3): 609–610. doi:10.1111/j.1365-2133.2006.07704.x. PMID 17300272.
- ↑ Shiohara T, Iijima M, Ikezawa Z, Hashimoto K. (2007). "The diagnosis of DRESS syndrome has been sufficiently established on the basis of typical clinical features and viral reactivations". Response Br J Dermatol. 156 (5): 1045–92. doi:10.1111/j.1365-2133.2007.07807.x. PMID 17381452.