Drug reaction with eosinophilia and systemic symptoms (DRESS) is a drug-induced hypersensitivity reaction that can have fatal complications. While substantial data exists regarding DRESS in adults, a systematic review of available literature has not been performed in children.
To review available data on DRESS in the pediatric population.
A systematic literature review was performed for pediatric DRESS (patients < 18 years of age).
A total of 82 articles with 148 patients were included. The majority experienced a skin rash (97.9%), and the liver was the second most common organ involved (84.5%). Among 143 patients for which treatment regimen was reported, the majority were treated with systemic steroids (85.3%). IVIG alone failed to improve symptoms in 5 patients who were initially misdiagnosed, while those treated with IVIG and steroids (2.7%) showed rapid clinical improvement. The mortality rate was low (3.0%). Complications included multi-organ failure and acute respiratory distress syndrome.
Limitations included limited availability of data for statistical analysis.
Pediatric DRESS commonly involves the liver. With treatment, the prognosis is commonly good, but serious complications may occur. Corticosteroids, possibly in conjunction with IVIG in severe cases, may serve as an effective, valuable treatment of pediatric DRESS.

Copyright © 2020. Published by Elsevier Inc.