Clinical characteristics and progress in diagnosis and treatment of drug reactions with eosinophilia and syste-mic symptoms in children / 中华实用儿科临床杂志

Drug reactions with eosinophilia and systemic symptom (DRESS) are a severe drug eruption, which is characterized by fever, rash, lymphadenopathy, hematological system abnormalities and involvement of internal organs.It also has such clinical characteristics as delayed onset, relapsing symptoms and reactivation of human herpesvi-ruses.The clinical characteristics of DRESS make it different from other drug reactions, with high clinical heterogeneity, variability and unpredictability.DRESS in children has some unique characteristics that are different from adults, such as culprit drugs, rash characteristics, and involved systems and organs.Moreover, the course of disease is shorter, the severity is milder, the morbidity and mortality are lower, and the prognosis is better compared with adults.In this paper, the clinical characteristics and progress in diagnosis and treatment of DRESS in children are reviewed.

Validation of a Rapid, Robust, Inexpensive Screening Method for Detecting the HLA-B*58:01 Allele in the Prevention of Allopurinol-Induced Severe Cutaneous Adverse Reactions

The HLA B*58:01 allele has been worldwide reported as a pharmacogenetic susceptibility to allopurinol-induced severe cutaneous adverse reactions (SCARs). To prevent these life-threatening conditions, the American College of Rheumatology hingly recommended that the HLA-B*58:01 be screened prior to the initiation of allopurinol therapy. Therefore, we developed a rapid, robust, inexpensive screening method using SYBR® Green real time PCR to detect the HLA-B*58:01 allele. A total of 119 samples were tested. The assay has a sensitivity of 100% (95% CI: 69.15%-100%), a specificity of 100% (95% CI: 96.67%-100%), a positive predictive value of 100% (95% CI: 69.15%-100%) and a negative predictive value of 100% (95% CI: 96.67%-100%). HLA-B*58:01 genotyping results showed 100% agreement with those obtained from Luminex SSO/SBT/SSP. The lowest limit of detection of this method is 0.8 ng/µL of DNA. The unit cost of the test is only $3.8 USD. This novel screening test using SYBR® real time PCR would be appropriate to identify individuals with the HLA-B*58:01 allele for the prevention of allopurinol-induced SCARs.