LAUSR

The prevalence of each RegiSCAR category in this study is similar to that in other publications on DRESS. This study differs as it recorded AEM. The results show that AEM appeared in DRESS as often as the established RegiSCAR criteria, including hepatic abnormalities and acute kidney injury. AEM was significantly more prevalent in patients with DRESS than in patients with other drug eruptions. The cause of AEM in DRESS is not known. This phenomenon may be due to disease involvement of the hematologic organ systems. Toxic eosinophilic granule proteins released during DRESS are thought to mediate organ damage and may affect the bone marrow, liver, and/or spleen and account for abnormalities seen in multiple blood cell lines. Our study supports this theory by showing that patients with DRESS and AEM were more likely to have eosinophilia and hepatic involvement than were patients without AEM. Limitations of this study include small sample size at a single medical center. Larger multicenter studies are needed to determine whether this finding can be replicated elsewhere. The presence of AEM may aid in the diagnosis of DRESS and could be evaluated as a component of the diagnostic scoring system.