A NEW international study has developed and validated prognostic models using novel inflammatory markers to predict in-hospital mortality in patients with drug reaction with eosinophilia and systemic symptoms (DRESS), a rare but life-threatening hypersensitivity reaction. The findings may help clinicians stratify risk early and intervene more effectively.
Researchers analyzed data from 169 patients across hospitals in Taiwan, Singapore, and Japan, all diagnosed with DRESS. By focusing on laboratory values collected within three days of diagnosis, they examined the prognostic significance of several inflammatory markers. Statistical modeling revealed that a lower hemoglobin-to-red blood cell distribution width (RDW) ratio, a higher platelet-to-lymphocyte ratio, and a reduced monocyte count were independently associated with an increased risk of death during hospitalization.
These markers were incorporated into a predictive model alongside the presence of underlying conditions such as malignancies, autoimmune disorders, and cardiovascular disease. The resulting model showed good discriminatory ability, suggesting it could be a valuable tool in clinical decision-making.
The retrospective design and factors such as interhospital transfer and comorbid malignancies were acknowledged as study limitations. Nevertheless, this risk model offers a meaningful advancement in the early identification of high-risk DRESS patients, addressing a critical gap in the management of severe cutaneous adverse reactions.
As the incidence of drug-induced hypersensitivity syndromes grows with expanding therapeutic options, the ability to anticipate outcomes with greater accuracy may improve triage decisions and potentially save lives.
Reference:
Hsieh T-S et al. Development and validation of prognostic models using novel inflammatory markers for drug reactions with eosinophilia and systemic symptoms: An international multicenter cohort study. J Am Acad Dermatol. 2025:S0190-9622(25)02380-1.
