ArticleThe journal of allergy and clinical immunology. In practice2024
Interleukin (IL)-1/IL-6-Inhibitor-Associated Drug Reaction With Eosinophilia and Systemic Symptoms (DReSS) in Systemic Inflammatory Illnesses.
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Article in The journal of allergy and clinical immunology. In practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Radiological Change in Interstitial Lung Abnormalities and Interstitial Lung Disease in Patients With Rheumatoid Arthritis at 1 Year.International journal of rheumatic diseases · 2026Article
- Challenging diagnosis of drug reaction with eosinophilia and systemic symptoms (DRESS) in a patient with adult-onset Still disease.JAAD case reports · 2026Article
- Benralizumab response in adult-onset Still's disease with eosinophilic complications and associated lung disease: DRESS or biologics-induced cytokine imbalance?EULAR rheumatology open · 2026Article
- Type I Interferon Signature is Associated With Lung Disease, Drug-Associated Immune Reactions, and Genetic Variation in Interferon-Linked Pathways in Still Disease.Arthritis & rheumatology (Hoboken, N.J.) · 2026Article
- Examination of HLA-DRB1*15-linked Candidate Antigens in Still Disease With and Without Lung Disease and Drug-Associated Immune Reactions.The Journal of rheumatology · 2026Article
- Efficacy of combined JAK1/2 inhibition and cyclosporine in paediatric-onset Still's disease with lung involvement: a case report.Pediatric rheumatology online journal · 2026Article
- Decoding pulmonary risk in childhood-onset still's disease: immunogenetic determinants and implications for risk stratification.Respiratory research · 2026Article
- Medication-induced lung disease in children.Pediatric radiology · 2026Review
- Rheumatoid nodule masquerading as a bone metastasis: a diagnostic case report.Annals of medicine and surgery (2012) · 2025Article
- Comparative risk of systemic autoimmune diseases in juvenile idiopathic arthritis treated with TNF-α or IL-6 inhibitors: a real-world cohort study.Frontiers in immunology · 2025Article
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Authors and funding
85 authors.
Vivian E SaperDepartment of Pediatrics, Stanford University School of Medicine, Stanford, Calif. Electronic address: vesaper@stanford.edu.
Lu TianDepartment of Biomedical Data Science, Stanford University, Stanford, Calif.
Ruud H J VerstegenHospital for Sick Children, Division of Clinical Pharmacology and Toxicology, Toronto, Ontario, Canada.
Carol K ConradDepartment of Pediatrics, Stanford University School of Medicine, Stanford, Calif.
Michal CidonDepartment of Pediatrics, Children's Hospital of Los Angeles, Los Angeles, Calif.
Rachel K HopperDepartment of Pediatrics, Stanford University School of Medicine, Stanford, Calif.
Christin S KuoDepartment of Pediatrics, Stanford University School of Medicine, Stanford, Calif.
Kazutoyo OsoegawaHistocompatibility & Immunogenetics Laboratory, Stanford Blood Center, Palo Alto, Calif.
Kevin BaszisDepartment of Pediatrics, Washington University in Saint Louis School of Medicine, Saint Louis, Mo.
Catherine A BinghamPennsylvania State University College of Medicine, Hershey, Pa.
Ian FergusonDepartment of Pediatrics, Yale University School of Medicine, New Haven, Conn.
Timothy HahnPennsylvania State University College of Medicine, Hershey, Pa.
Annacarin HorneDepartment of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
Eugenia A IsupovaSaint Petersburg State Pediatric Medical University, Saint Petersburg, Russia.
Jordan T JonesChildren's Mercy Hospital, Kansas City, Mo; University of Kansas School of Medicine, Kansas City, Mo.
Özgür KasapcopurDepartment of Pediatrics, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Marisa S Klein-GitelmanDepartment of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill; Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.
Mikhail M KostikSaint Petersburg State Pediatric Medical University, Saint Petersburg, Russia.
Seza OzenDepartment of Pediatrics, Hacettepe University, Ankara, Turkey.
Omkar PhadkeUniversity Hospitals Rainbow Babies & Children's Hospital, Cleveland, Ohio.
Sampath PrahaladDepartment of Pediatrics, Emory University School of Medicine, Atlanta, Ga; Children's Healthcare of Atlanta, Atlanta, Ga.
Rachel L RandellDepartment of Pediatrics, Duke University School of Medicine, Durham, NC.
Seher SenerDepartment of Pediatrics, Hacettepe University, Ankara, Turkey.
Cory StinglCorewell Health, Grand Rapids, Mich.
Rabheh Abdul-AzizUniversity at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY.
Shoghik AkoghlanianDepartment of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio.
Dalila Al JulandaniBristol Royal Hospital for Children Bristol, University of Bristol, Bristol, United Kingdom.
Marcela B AlvarezHospital de Niños Dr Ricardo Gutierrez, Buenos Aires, Argentina.
Brigitte Bader-MeunierHopital Universitaire Necker-Enfants Malades, Department of Paediatric Hematology-Immunology and Rheumatology, Reference Center for Rheumatic, AutoImmune and Systemic diseases in children (RAISE), Imagine Institute, Inserm, Paris, France.
Erin E Balay-DustrudeSeattle Children's Hospital Research Center, Seattle, Wash; Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash.
Imelda BalboniDepartment of Pediatrics, Stanford University School of Medicine, Stanford, Calif.
Sarah K BaxterSeattle Children's Hospital Research Center, Seattle, Wash; Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash.
Roberta A BerardChildren's Hospital, London Health Sciences Centre, London, Ontario, Canada.
Sagar BhattadPediatric Immunology and Rheumatology, Aster CMI Hospital, Bangalore, Karnataka, India.
Roxana BolariaDepartment of Pediatrics, University of British Columbia, Victoria, British Columbia, Canada.
Alexis BoneparthDepartment of Pediatrics, Columbia University Irving Medical Center, New York, NY.
Elaine A CassidyDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, Pa.
Dominic O CoDepartment of Pediatrics, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wis.
Kathleen P CollinsThe University of Tennessee Health Science Center, Memphis, Tenn; LeBonheur Children's Hospital, Memphis, Tenn.
Paul DanceyJaneway Children's Health and Rehabilitation Centre and Memorial University, St. John's, Newfoundland and Labrador, Canada.
Aileen M DickinsonDepartment of Pediatrics, University of California Los Angeles David Geffen School of Medicine, Los Angeles, Calif.
Barbara S EdelheitUniversity of Connecticut School of Medicine, Farmington, Conn; Connecticut Children's Medical Center, Hartford, Conn.
Graciela EspadaHospital de Niños Dr Ricardo Gutierrez, Buenos Aires, Argentina.
Elaine R FlanaganDepartment of Pediatrics, Emory University School of Medicine, Atlanta, Ga; Children's Healthcare of Atlanta, Atlanta, Ga.
Lisa F ImundoDepartment of Pediatrics, Columbia University Irving Medical Center, New York, NY.
Ankur K JindalPost Graduate Institute of Medical Education and Research, Chandigarh, India.
Hyoun-Ah KimDepartment of Rheumatology, Ajou University School of Medicine, Suwon, Republic of Korea.
Günter KlausPhilipps-University of Marburg and KfH Pediatric Kidney Center, Marburg, Germany.
Carol LakeTranslational Genetics and Genomics Section, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health, Bethesda, Md.
W Blaine LapinUniversity of Connecticut School of Medicine, Farmington, Conn; Connecticut Children's Medical Center, Hartford, Conn.
Erica F LawsonUniversity of California San Francisco, San Francisco, Calif.
Itay MarmorDana-Dwek Children's Hospital Tel Aviv, Tel Aviv, Israel.
Joy MombourquetteDepartment of Pediatrics, Kaiser Permanente California, Roseville, Calif.
Benson OgunjimiCentre for Health Economics Research and Modeling of Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.
Rebecca OlvedaUniversity of California San Francisco, San Francisco, Calif.
Michael J OmbrelloTranslational Genetics and Genomics Section, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health, Bethesda, Md.
Karen OnelHospital for Special Surgery, New York, NY; Department of Pediatrics, Weill Cornell Medicine, New York, NY.
Catherine PoholekDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, Pa.
Athimalaipet V RamananUniversity of Bristol Faculty of Health Sciences, Bristol, United Kingdom.
Angelo RavelliIRCCS Istituto Giannina Gaslini, Genova, Italy; Università degli Studi di Genova, Genova, Italy.
Adam ReinhardtBoys Town National Research Hospital, Omaha, Neb.
Amanda D RobinsonDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, Pa.
Kelly Rouster-StevensDepartment of Pediatrics, Emory University School of Medicine, Atlanta, Ga; Children's Healthcare of Atlanta, Atlanta, Ga.
Nadine SaadUniversity of Michigan, Michigan Medicine, Ann Arbor, Mich.
Rayfel SchneiderHospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
Velma SelmanovicChildren's Hospital University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina.
Irmina Sefic PasicChildren's Hospital University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina.
Susan ShenoiSeattle Children's Hospital Research Center, Seattle, Wash; Department of Pediatrics, University of Washington School of Medicine, Seattle, Wash.
Natalie R ShiloDepartment of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pa.
Jennifer B SoepUniversity of Colorado School of Medicine, Aurora, Colo.
Angeli SuraState University of New York (SUNY) Upstate Medical University, Syracuse, NY.
Sarah F TaberHospital for Special Surgery, New York, NY; Department of Pediatrics, Weill Cornell Medicine, New York, NY.
Melissa TesherUniversity of Chicago Pritzker School of Medicine, Chicago, Ill.
Jessica TibaldiUniversità degli Studi di Genova, Genova, Italy.
Kathryn S TorokDepartment of Pediatrics, University of Pittsburgh, Pittsburgh, Pa.
Cathy Mei TsinDepartment of Pediatrics, Stanford University School of Medicine, Stanford, Calif.
Natalia Vasquez-CanizaresThe Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY.
Diana S Villacis NunezDepartment of Pediatrics, Emory University School of Medicine, Atlanta, Ga; Children's Healthcare of Atlanta, Atlanta, Ga.
Emily E WayInova L.J. Murphy Children's Hospital, Falls Church, Va.
Benjamin WhiteheadQueensland Children's Hospital, South Brisbane, Queensland, Australia.
Lawrence S ZemelUniversity of Connecticut School of Medicine, Farmington, Conn; Connecticut Children's Medical Center, Hartford, Conn.
Surbhi SharmaDepartment of Pediatrics, Stanford University School of Medicine, Stanford, Calif.
Marcelo A Fernández-ViñaHistocompatibility & Immunogenetics Laboratory, Stanford Blood Center, Palo Alto, Calif; Department of Pathology, Stanford University School of Medicine, Stanford, Calif.
Elizabeth D MellinsDepartment of Pediatrics, Stanford University School of Medicine, Stanford, Calif.
CARRA Registry Investigators
Funding
Genetics and pathophysiology of systemic juvenile idiopathic arthritis and other complex autoinflammatory diseasesZIAAR041198 · NIAMS · NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES · PI OMBRELLO, MICHAEL · 2014 to 2025
$14.4MUNC-Duke Collaborative Clinical Pharmacology Postdoctoral Training Program-Evaluation SupplementT32GM086330 · NIGMS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI KIM L.R. BROUWER, Daniel Gonzalez · 2011 to 2026
$8.5MTraining Program in Adult and Pediatric RheumatologyT32AR050942 · NIAMS · STANFORD UNIVERSITY · PI LEWIS, DAVID BRAM, ROBINSON, WILLIAM H · 2005 to 2025
$6.6MDuke-UNC Collaborative Pediatric Clinical Pharmacology Postdoctoral Training ProgramT32HD104576 · NICHD · DUKE UNIVERSITY · PI BROUWER, KIM L.R., GONZALEZ, DANIEL · 2021 to 2025
$962kIntramural NIH HHS ZIA AR041198NIAMS NIH HHS T32 AR050942NICHD NIH HHS T32 HD104576NIGMS NIH HHS T32 GM086330
Abstract
backgroundAfter introducing IL-1/IL-6 inhibitors, some patients with Still and Still-like disease developed unusual, often fatal, pulmonary disease. This complication was associated with scoring as DReSS (drug reaction with eosinophilia and systemic symptoms) implicating these inhibitors, although DReSS can be difficult to recognize in the setting of systemic inflammatory disease.
objectiveTo facilitate recognition of IL-1/IL-6 inhibitor-DReSS in systemic inflammatory illnesses (Still/Still-like) by looking at timing and reaction-associated features. We evaluated outcomes of stopping or not stopping IL-1/IL-6 inhibitors after DReSS reaction began.
methodsIn an international study collaborating primarily with pediatric specialists, we characterized features of 89 drug-reaction cases versus 773 drug-exposed controls and compared outcomes of 52 cases stopping IL-1/IL-6 inhibitors with 37 cases not stopping these drugs.
resultsBefore the reaction began, drug-reaction cases and controls were clinically comparable, except for younger disease-onset age for reaction cases with preexisting cardiothoracic comorbidities. After the reaction began, increased rates of pulmonary complications and macrophage activation syndrome differentiated drug-reaction cases from drug-tolerant controls (P = 4.7 × 10
conclusionsIn systemic inflammatory illnesses, recognition of IL-1/IL-6-inhibitor-associated reactions followed by avoidance of IL-1/IL-6 inhibitors significantly improved outcomes.
Indexed as
Drug Hypersensitivity SyndromeInterleukin-1Interleukin-6 InhibitorsAdolescentChildChild, PreschoolFemaleHumansInfantMaleInterleukin-1Interleukin-6 InhibitorsBiologic therapyDrug-induced lung diseaseDrug reaction with eosinophilia and systemic symptomsHemophagocytic lymphohistiocytosisMacrophage activation syndromePulmonary hypertensionStill diseaseSystemic inflammatory illnesses
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.