Characteristics and evaluations of different diagnostic criteria for drug-induced hypersensitivity syn-drome:a report of 75 cases
OBJECTIVE To explore the clinical characteristics of drug-induced hypersensitivity syndrome(DIHS)and com-pare differential outcomes through various diagnostic criteria to provide references for early clinical diagnosis and safe and rational drug dosing.METHODS From 2017 to 2021,the relevant clinical data were retrospectively reviewed for 75 hospitalized DIHS patients according to the RegiSCAR criteria.J-SCAR criteria and RegiSCAR scoring system were utilized for comparing the dif-ferential outcomes.RESULTS Among them,the major sensitizing drugs were antiepileptic agents(n=26),allopurinol(n=17)and antibiotics(n=16).The incubation period was(10-30)day(78.7％).The major clinical manifestations were rash(100.0％),fever(94.7％),liver injury(96.0％)and eosinophilia(49.3％).Ten patients on allopurinol tested positive for HLA-B*58:01 gene.Treatment was offered with glucocorticoids or plus intravenous immunoglobulin.Finally 70 patients improved while another 5 died.Twenty-seven patients(36.0％)fit the J-SCAR criteria for atypical DIHS and 63 patients(84.0％)met the RegiSCAR scoring system for probable/possible DIHS.The mortality rate of patients with RegiSCAR score ≥3 was significantly higher than that of those with RegiSCAR score＜3(P＜0.05).CONCLUSION DIHS is severe and recur rent with a high mortality rate.Whenever there is a history of suspicious drug dosing,RegiSCAR scoring system may be utilized for identifying critically ill patients timely and lowering mortality.
drug-induced hypersensitivity syndromedrug-induced diseaseallopurinolRegiSCAR scoring system
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