Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=28315874
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\28315874
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Int+Arch+Allergy+Immunol
2017 ; 172
(3
): 129-138
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Multiple Drug Hypersensitivity
#MMPMID28315874
Pichler WJ
; Srinoulprasert Y
; Yun J
; Hausmann O
Int Arch Allergy Immunol
2017[]; 172
(3
): 129-138
PMID28315874
show ga
Multiple drug hypersensitivity (MDH) is a syndrome that develops as a consequence
of massive T-cell stimulations and is characterized by long-lasting drug
hypersensitivity reactions (DHR) to different drugs. The initial symptoms are
mostly severe exanthems or drug rash with eosinophilia and systemic symptoms
(DRESS). Subsequent symptoms due to another drug often appear in the following
weeks, overlapping with the first DHR, or months to years later after resolution
of the initial presentation. The second DHR includes exanthema, erythroderma,
DRESS, Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), hepatitis,
and agranulocytosis. The eliciting drugs can be identified by positive skin or in
vitro tests. The drugs involved in starting the MDH are the same as for DRESS,
and they are usually given in rather high doses. Fixed drug combination therapies
like sulfamethoxazole/trimethoprim or piperacillin/tazobactam are frequently
involved in MDH, and 30-40% of patients with severe DHR to combination therapy
show T-cell reactions to both components. The drug-induced T-cell stimulation
appears to be due to the p-i mechanism. Importantly, a permanent T-cell
activation characterized by PD-1+/CD38+ expression on CD4+/CD25low T cells can be
found in the circulation of patients with MDH for many years. In conclusion, MDH
is a drug-elicited syndrome characterized by a long-lasting hyperresponsiveness
to multiple, structurally unrelated drugs with clinically diverse symptoms.