J Pharmacoepidemiol Risk Manage.  2022 Mar;14(1):47-50. 10.56142/2022.14.1.47.

An Overview of Multiple Drug Hypersensitivity Syndrome

• Sohn KH

• KMID: 2534673
• DOI: http://doi.org/10.56142/2022.14.1.47

Abstract

The multiple drug hypersensitivity syndrome (MDHS) is a novel condition characterized by a delayed hypersensitivity reaction to two structurally different drugs. It is important to be able to distinguish between MDHS and multiple drug intolerance and/or flare-up reactions. MDHS should thus be confirmed using delayed intradermal tests, patch tests or in vitro tests. Recent studies have reported that the initial reactions manifest most commonly as a drug reaction with eosinophilia and systemic symptoms (DRESS); fixed combination antibiotics such as sulfamethoxazole/trimethoprim or piperacillin/tazobactam are frequently involved in MDHS. The occurrence of MDHS depends on the status of previous T cell activations, and its immune response is similar to that seen in graft versus host disease and viral infections. The first drug hypersensitivity response lowers the T cell proliferation threshold for the drug and causes a rapid appearance of hypersensitivity symptoms to the second drug. Accurate diagnosis of MDHS is needed for its proper management.

Keyword

Multiple drug hypersensitivity; Drug reaction with eosinophilia and systemic symptoms (DRESS); Drug hypersensitivity