C-Reactive Protein and Procalcitonin in Case Reports of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome.

Hübner, Simona T; Bertoli, Raffaela; Rätz Bravo, Alexandra E; Schaueblin, Martina; Haschke, M.; Scherer, Kathrin; Ceschi, Alessandro; Leuppi-Taegtmeyer, Anne B (2018). C-Reactive Protein and Procalcitonin in Case Reports of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome. International archives of allergy and immunology, 176(1), pp. 44-54. Karger 10.1159/000487670

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BACKGROUND The spectrum of inflammatory marker response in DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome has not been systematically characterized. METHODS An epidemiological biomarker study of C-reactive protein (CRP) and procalcitonin (PCT) values in patients with DRESS syndrome reported at 2 regional pharmacovigilance centers in Switzerland or published in the medical literature 2008-2016 was performed. RESULTS Ninety-four DRESS cases were studied. All cases showed a CRP value > 10 mg/L (the upper limit of normal). The mean CRP value was 109.2 ± 79.4 mg/L. CRP values were significantly higher in 22 cases where a cause of inflammation besides DRESS could not be excluded (mean 162.1 vs. 92.9 mg/L; p = 0.003). Receiver operator characteristics curve analysis showed a moderate performance with a CRP cut-off value of 99.4 mg/L (AUC 0.717) to distinguish between patients with and without a possible additional cause of inflammation. The mean and median PCT values were 2.44 ± 5.94 and 0.69 ng/mL, respectively (n = 25 patients). Patients in whom an additional cause of inflammation besides DRESS could not be excluded showed a median PCT of 1.37 ng/mL (n = 9) versus 0.67 ng/mL (n = 16) in patients with DRESS only. PCT values were above the normal cut-off of 0.1 ng/mL, suggestive of bacterial infection in all but 1 case. Furthermore, there was a correlation between PCT values and hepatic enzyme measurements. CONCLUSIONS Evaluating CRP and PCT values might be of use in helping physicians to distinguish between cases of DRESS syndrome with and without concurrent infection or other causes of inflammation. Further prospective investigation is required to define the use of these inflammatory markers in the management of DRESS.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Pharmacology
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Haschke, Manuel Martin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1018-2438

Publisher:

Karger

Language:

English

Submitter:

Christine Baumgartner

Date Deposited:

09 Jan 2019 09:58

Last Modified:

09 Jan 2019 09:58

Publisher DOI:

10.1159/000487670

PubMed ID:

29656292

Uncontrolled Keywords:

C-reactive protein DRESS syndrome Drug reaction with eosinophilia and systemic symptoms Inflammatory markers Liver enzymes Procalcitonin

URI:

https://boris.unibe.ch/id/eprint/123176

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