《Table 2 Liver involvement reported in drug reaction, eosinophilia, and systemic symptoms syndrome/d

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《"Liver involvement in the drug reaction,eosinophilia,and systemic symptoms syndrome"》

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1Case series with Anticonvulsant hypersensitivity syndrome.2Authors reported that DReSS induced by phenytoin appeared sooner after the drug intake compared to carbamazepine（P=0.01）.3Allopurinol was related to cholestatic pattern.Hepatocellular-type patte

In this review，we will use the acronym DReSS/DiHS instead of DRESS as a recent review highlighted the importance of clarifying that eosinophilia is not mandatory to confirm this syndrome[18].In 1996，Bocquet et al[19]established three criteria needed for diagnosis of DReSS/DiHS syndrome:skin eruption，eosinophilia（≥1.5×109/μL），and visceral involvement（transaminase elevation≥2 times upper normal limit，lymphadenopathy>2 cm in diameter，nephritis，interstitial pneumonia，or carditis）.In 2006，Shiohara et al[20]proposed to include as diagnostic criteria the presence of human herpes virus 6（HHV-6）reactivation，as they documented HHV-6 IgG titers and DNA 2-3 wk after the onset of the rash.The group suggested this virus to be a cause of this hypersensitivity syndrome.Finally，in 2007 the RegiSCAR group developed a new scoring system.Hospital admission as a result of the suspected drug-related reaction and at least three of the following findings:acute skin rash，fever，lymphadenopathy of at least two sites，the involvement of at least one internal organ，lymphocytosis/lymphocytopenia，peripheral eosinophilia，and thrombocytopenia.According to this scoring system，patients were classified into definite，probable，possible，or no diagnosis of DReSS/DiHS（Table 1）[21].