Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Treatment

Stop offending agents:

 • List as allergies in EMR

 • Don't re-challenge!

Steroids for severe systemic dz:

 • Methylprednisolone 0.5 - 1.5 mg/kg with slow taper over 8+ weeks

 • Alternatives: cyclosporine, IVIG etc

 • Skin: topical steroid +/- oral antihistamine for pruritis

Continued monitoring:

 • CBC with Diff, manual absolute Eos count daily

 • LFTs daily

 • Cr daily

 • Watch for mucosal involvement -> alternate dx



- BWH Medicine Chiefs @BrighamChiefs



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