Utility of Patch Testing, LTT, and HLA Genotyping in Identifying Culprit Drugs and Diagnosing Multiple Drug Hypersensitivity in Definite DRESS: A 10-Year Cohort Study.
Multiple drug hypersensitivity was far more common in severe Drug Reaction with Eosinophilia and Systemic Symptoms cases
Utility of Patch Testing, LTT, and HLA Genotyping in Identifying Culprit Drugs and Diagnosing Multiple Drug Hypersensitivity in Definite DRESS: A 10-Year Cohort Study.
We evaluated the role of lymphocyte transformation test (lymphocyte transformation test), patch testing (patch testing), and human leukocyte antigen (human leukocyte antigen) genotyping in identifying culprit drugs in Drug Reaction with Eosinophilia and Systemic Symptoms (Drug Reaction with Eosinophilia and Systemic Symptoms) and assessed long-term outcomes.
Were grouped by single- or multiple drug exposure.
multi-drug allergy was far more common in severe cases than mild or moderate ones
6 [6-7]; p = 0.012) and more frequent facial edema (p < 0.001) and lymphadenopathy (p = 0.029).
Among 20 patients with multiple drug exposures, 10 were diagnosed with multiple drug hypersensitivity syndrome: 5 simultaneous, 2 sequential, and 4 long-interval; one patient exhibited both simultaneous and long-interval reactions.
6 [6-8]; p < 0.001) and a higher prevalence of human leukocyte antigen risk alleles (p = 0.038), including human leukocyte antigen-B*58:01 (allopurinol), human leukocyte antigen-A*31:01 (carbamazepine), human leukocyte antigen-B*13:02 (levofloxacin) and human leukocyte antigen-A*24:02 (lamotrigine).
Patch testing and lymphocyte transformation test effectively identified culprit drugs in Drug Reaction with Eosinophilia and Systemic Symptoms, particularly in multiple drug exposure.
multiple drug hypersensitivity syndrome was more frequent in severe Drug Reaction with Eosinophilia and Systemic Symptoms and associated with a higher prevalence of drug-related human leukocyte antigen risk alleles; however, no single human leukocyte antigen marker defined multiple drug hypersensitivity syndrome.
Long-term follow-up was essential to detect autoimmune sequelae and neo-sensitization, and to guide safe drug evaluation and reintroduction.