cliot (version 1.0.0)

regiscar_dress_score: RegiSCAR Score for DRESS Syndrome

Description

Calculates the RegiSCAR score to diagnose Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). The score evaluates clinical features including fever, lymphadenopathy, hematologic abnormalities, skin involvement, organ involvement, and exclusion of other causes.

Usage

regiscar_dress_score(fever_gt_385, lymphadenopathy, eosinophil_count,
                     atypical_lymphocytes, skin_extent_gt_50,
                     skin_suggestive_features, organ_involvement_count,
                     other_causes_excluded, resolution_gt_15_days = 1)

Value

A list containing:

RegiSCAR_Score

The calculated total score.

Diagnosis

Diagnostic classification (No, Possible, Probable, or Definite DRESS).

Arguments

fever_gt_385

Numeric (0 or 1). Fever > 38.5 degrees Celsius. (1 = Yes, +1 point).

lymphadenopathy

Numeric (0 or 1). Enlarged lymph nodes in >= 2 sites (> 1 cm). (1 = Yes, +1 point).

eosinophil_count

Numeric. Absolute Eosinophil Count (cells/uL). (>= 700: +1, >= 1500: +2).

atypical_lymphocytes

Numeric (0 or 1). Presence of atypical lymphocytes. (1 = Yes, +1 point).

skin_extent_gt_50

Numeric (0 or 1). Skin rash extent > 50% body surface area. (1 = Yes, +1 point).

skin_suggestive_features

Numeric (0 or 1). Presence of at least 2 suggestive skin features (e.g., infiltration, purpura, scaling, facial edema). (1 = Yes, +1 point).

organ_involvement_count

Numeric. Number of internal organs involved (e.g., liver, kidney, lung). (1 organ: +1, >=2 organs: +2).

other_causes_excluded

Numeric (0 or 1). Were other potential causes (e.g., viral infections, ANA, blood culture) excluded? (1 = Yes, +1 point).

resolution_gt_15_days

Numeric (0 or 1). Did the reaction last more than 15 days? (1 = Yes, 0 pts; 0 = No, -1 point). Defaults to 1 (Yes) as DRESS is typically persistent.

References

Kardaun SH, Sidoroff A, Valeyrie-Allanore L, et al. Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist? Br J Dermatol. 2007;156(3):609-611. doi:10.1111/j.1365-2133.2006.07704.x

Examples

# Example 1: Probable DRESS
# Fever(+1), Eos 900(+1), Atypical Lymphs(+1), Rash >50%(+1), No organs(0)
# Score = 4
regiscar_dress_score(1, 0, 900, 1, 1, 0, 0, 0, 1)

# Example 2: Definite DRESS
# Fever(+1), Nodes(+1), Eos 2000(+2), Rash Feat(+1), Liver/Kidney(+2)
# Score = 7
regiscar_dress_score(1, 1, 2000, 0, 0, 1, 2, 0, 1)