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

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.