Autoimmune diseases, end organ dysfunction and adverse drug reaction following Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): A retrospective cohort study

Context: Autoimmune diseases, organ dysfunction and new drug allergies are mentioned as long-term complications after DRESS. There is scarcity of data on this from the country. Aims: To determine the frequency of autoimmune diseases, organ dysfunction, and new drug allergies after the resolution of DRESS. Settings and Design: This retrospective cohort study was carried out among patients who received treatment for DRESS in a tertiary referral center. Materials and Methods: In this retrospective cohort study, DRESS patients who received inpatient care in the dermatology department of our tertiary referral center from August 2014 to February 2017 were included. We excluded patients aged 12 years or below and those who had not completed minimum two years after the resolution of DRESS as on December 2019. We collected information on new onset autoimmune disease, end organ damage and new drug allergies detected after the resolution of DRESS through a telephonic interview. Those who consented were evaluated in our department. Results: We could contact 40/50 (80%) identified individuals and all of them consented for telephonic interview. 17 patients gave consent for revaluation in our department. There were 22 females and 18 males. 17 had definite and 23 had probable DRESS. The frequency of detection of a new disease and a new drug allergy after DRESS was 10% (4/40) and 7.5% (3/40), respectively. We noted three (7.5%) autoimmune diseases (rheumatoid arthritis 1, alopecia areata 1, chronic autoimmune urticaria 1) and one end organ damage (chronic kidney disease) among the study participants. Limitations: Small sample size and retrospective study design were the limitations. Conclusions: Prospective studies with large sample size are needed to delineate the link between DRESS and autoimmunity, end organ damage, and new drug allergies.