Allergy Asthma Respir Dis.  2013 Jun;1(2):144-150. 10.4168/aard.2013.1.2.144.

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

• Park MR
• Nam YH
• Jeong IH
• Lee HW
• Kim YJ
• Park IC
• Cho DS
• Yoon NB
• Um SJ
• Son CH
• Lee SK

• KMID: 2261862
• DOI: http://doi.org/10.4168/aard.2013.1.2.144

Abstract

PURPOSE
Vitamin D deficiency (VDD) is widely spread and on the increase throughout the world. Although vitamin D is essential for skeletal mineralization, VDD or vitamin D insufficiency (VDI) has been associated with nonskeletal disorders including cardiovascular disease, cancer, allergic disease and skin disease. However, a few reports showed the association of vitamin D and drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. Thereafter, we evaluated the association between vitamin D and DRESS syndrome.
METHODS
We conducted a retrospective study on 45 patients with DRESS syndrome. Four hundred and ninty-eight healthy people who visited the health screening center were enrolled in the study as a control group. We investigated the clinical characteristics, the causative drugs and treatments in the patients with DRESS syndrome, and also analyzed the associations with serum 25-hydroxyvitamin D (25(OH)D3).
RESULTS
Forty-four patients (97.8%) had low serum vitamin D levels; 21 patients were VDD (serum 25(OH)D3 <10 ng/mL), and 23 patients were VDI (serum 25(OH)D3 10 to 30 ng/mL). There were no significant differences in clinical parameters between two groups. Serum 25(OH)D3 level of the study patients was significantly lower that of the controls (12.3+/-9.6 ng/mL vs. 17.3+/-5.5 ng/mL, P<0.001). Serum 25(OH)D3 level showed a significant negative correlation with admission days (r=-0.377, P=0.011).
CONCLUSION
The majority of the patients with DRESS syndrome showed low vitamin D levels. Serum 25(OH)D3 was inversely correlated with admission days.

Keyword

Drug hypersensitivity; Vitamin D

MeSH Terms

Cardiovascular Diseases
Drug Hypersensitivity
Eosinophilia
Humans
Mass Screening
Retrospective Studies
Skin Diseases
Vitamin D
Vitamin D Deficiency
Vitamins
Vitamin D
Vitamins

Figure

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  Fig. 1 The frequency of causative drugs. NSAIDs, nonsteroidal anti-inflammatory drugs; Mixed, the combination of two or more drugs; Other, drugs not described above; Unknown, drugs not identified.

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  Fig. 2 The frequency of causative drugs according to the serum levels of 25-hydroxyvitamin D. Deficiency, subjects with serum 25-hydroxyvitamin D level <10 ng/mL; Insufficiency, subjects with serum 25-hydroxyvitamin D level between 10 and 30 ng/mL; Noninsufficiency, subjects with serum 25-hydroxyvitamin D level>30 ng/mL; Unknown, drugs not identified; Others, drugs not described above; Mixed, the combination of two or more drugs; NSAIDs, nonsteroidal anti-inflammatory drugs.

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