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P KZN DRESS SYNDROME
Pediatric drug reaction with eosinophilia and systemic symptoms: A systematic review of the literature, with a focus on relapsing cases
Abstract
Background
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe cutaneous adverse drug reaction with systemic symptoms. This study aims to investigate clinical features, causative drugs, and available treatments for pediatric DRESS, particularly for relapsing cases.
Methods
A systematic search of the English and French literature on pediatric DRESS was conducted using the Medline, Embase, and Cochrane collaboration databases. Confirmed cases of pediatric DRESS fulfilling the RegiSCAR diagnostic criteria with a probable or a definite diagnosis were included.
Results
After full‐text article review, 144 articles were included, representing a total of 354 pediatric patients with a mean age of 8.8 years. The mean time from the drug intake until the onset of the first symptom was 18.9 days. Antiepileptic drugs were the main trigger, followed by anti‐infectious agents. Relapsing DRESS was reported in 17 children. In comparison to non‐relapsing cases, relapsing patients had more comorbidities. The initial clinical presentation was more commonly erythroderma. Facial edema, fever, and enlarged lymph nodes in more than two sites were more commonly found in relapsing cases. Systemic steroids were more frequently administered.
Conclusion
Pediatric DRESS is a potentially severe adverse drug reaction. Antiepileptic agents are the most common causative agents. Fever, facial edema, lymph node enlargement, and pharyngeal and visceral involvement predicted DRESS reactivation in children. Corticosteroids were the mainstay of treatment.
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"Flatter me, and I may not believe you. Criticize me, and I may not like you. Ignore me, and I may not forgive you. Encourage me, and I will not forget you."
-- Author Unknown
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Mental health issues and obesity tend to develop together from as young as 7-years-old psyd
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Highly intelligent people are more likely to be generous and altruistic PSYD
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P KZN DMD XSTEROIDS
Vamorolone demonstrates efficacy, safety for boys with Duchenne muscular dystrophy
Treatment with vamorolone, an anti-inflammatory steroidal drug, improved motor outcomes in boys with Duchenne muscular dystrophy compared with corticosteroid-naive individuals, according to findings published in PLoS Medicine.
Vamorolone (ReveraGen)also resulted in fewer physician-reported adverse events compared with the number reported for treatment with prednisone and deflazacort and did not result in the stunting of growth that has been observed with these corticosteroids, the researchers reported.
“Treatment with corticosteroids is recommended for [patients with Duchenne muscular dystrophy (DMD)] to slow the progression of weakness. However, chronic corticosteroid treatment causes significant morbidities,” the researchers wrote. “Vamorolone is a first-in-class anti-inflammatory investigational drug that has shown evidence of efficacy in DMD after 24 weeks of treatment at [2 or 6 mg/kg per day]. Here, open-label efficacy and safety experience of vamorolone was evaluated over a period of 18 months in trial participants with DMD.”
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