Relationships between serum vitamin D levels and clinical characteristics of drug reaction with eosinophilia and systemic symptoms syndrome

Mi-Ran Park, Young-Hee Nam, Il-Hwan Jeong, Hye-Won Lee, Yong-Jun Kim, In-Chul Park, Duk-Song Cho, Neul-Bom Yoon, Soo-Jung Um, Choon-Hee Son, Soo-Keol Lee
2013 Allergy Asthma & Respiratory Disease  
Purpose:VitaminDdeficiency(VDD)iswidelyspreadandontheincreasethroughouttheworld.AlthoughvitaminDisessentialfor skeletalmineralization,VDDorvitaminDinsufficiency(VDI)hasbeenassociatedwithnonskeletaldisordersincludingcardiovasculardisease,cancer,allergicdiseaseandskindisease.However,afewreportsshowedtheassociationofvitaminDanddrugreaction witheosinophiliaandsystemicsymptoms(DRESS)syndrome.Thereafter,weevaluatedtheassociationbetweenvitaminDandDRESS syndrome.
more » ... 45patientswithDRESSsyndrome.Fourhundredandninty-eighthealthypeople whovisitedthehealthscreeningcenterwereenrolledinthestudyasacontrolgroup.Weinvestigatedtheclinicalcharacteristics, thecausativedrugsandtreatmentsinthepatientswithDRESSsyndrome,andalsoanalyzedtheassociationswithserum25-hy-droxyvitaminD(25(OH)D3). Results:Forty-fourpatients(97.8%)hadlowserumvitaminDlevels;21patientswereVDD(serum25(OH)D3 < 10ng/mL),and23 patientswereVDI(serum25(OH)D310to30ng/mL).Therewerenosignificantdifferencesinclinicalparametersbetweentwogroups. Serum25(OH)D3levelofthestudypatientswassignificantlylowerthatofthecontrols(12.3±9.6ng/mLvs.17.3±5.5ng/mL,P<0.001). Serum25(OH)D3levelshowedasignificantnegativecorrelationwithadmissiondays(r= -0.377,P= 0.011). Conclusion:ThemajorityofthepatientswithDRESSsyndromeshowedlowvitaminDlevels.Serum25(OH)D3wasinverselycorrelatedwithadmissiondays.(����������������������������������������� ����������������������������������������� Keywords:Drughypersensitivity,VitaminD 서 론 Drug reaction with eosinophilia and systemic symptoms (DRESS) 증후군은 일정 기간 이상 지속적인 약물 투여에 의한 피부 발진, 발 열 및 다발성 내부 장기 손상을 특징으로 한다. 이 질환은 1950년 Chaiken 등 1) 에 의해 dilantin hypersensitivity syndrome으로 처음 기술되었고, 통일된 명칭과 진단 기준은 아직 확립되지 않은 상태 로, 약물 유도성 과민 반응 증후군(drug-induced hypersensitivity syndrome, DIHS) 등으로 불리기도 한다. 2) DRESS 증후군의 발생 빈도에 대한 정확한 보고는 없으며, 항경 련제 또는 sulfonamides를 복용한 환자 1,000-10,000명 중 1명 발 생하는 것으로 알려져 있다. 3) 이 질환은 원인 약물 복용 후 임상 양 상이 나타나기까지 긴 잠복기를 가지며, phenytoin, carbamazepine, phenobarbital, primidone 등 방향족 항경련제가 가장 흔한 AllergyAsthmaRespirDis1(2):144-150,June2013 http://dx.
doi:10.4168/aard.2013.1.2.144 fatcat:cp2boahzhbdrfazds3tflbljia