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Is a Drug Alone Sufficient to Cause the Drug Hypersensitivity Syndrome?
Arch Dermatol. 2004;140:226-230.
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DRUG HYPERSENSITIVITY SYNDROME (DHS) can be defined as the clinical triad of fever, rash, and internal organ involvement due to drug exposure.1 Other groups use the term drug rash with eosinophilia and systemic symptoms (DRESS) to describe the same syndrome.2 Although the preferred nomenclature of the syndrome is debatable, the clinical features comprising the syndrome are agreed upon. The exact pathogenesis of this syndrome remains unknown, although several hypotheses have been proposed.1, 3-5 Clearly, drug exposure is a key factor in the etiology of these reactions. However, is a drug alone sufficient to cause DHS?
The pathophysiological mechanisms involved in the evolution of DHS are likely to represent a complex interaction between numerous constitutional and acquired factors resulting in a diverse clinical presentation. The association of viral infections and adverse drug reactions is illustrated by 2 well-known examples: the high incidence of skin eruptions in patients with infectious mononucleosis who are . . . [Full Text of this Article]
Gavin A. E. Wong, MBChB, MRCP(UK)
Toronto
Neil H. Shear, MD, FRCPC
Divisions of Dermatology and Clinical Pharmacology
University of Toronto
Sunnybrook & Women's College Health Sciences Centre
2075 Bayview Ave
Toronto, Ontario, Canada M4N 3M5
(e-mail: Neil.Shear@sw.ca)
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