Hassan Mobayed, Maryam Al-Nesf, Tayseer Ibrahim, Sami Aqel, Mona Al-Ahmad, Jean Bousquet
{"title":"Secondary Non-Response to Biologic Treatment in Patients with Severe Asthma.","authors":"Hassan Mobayed, Maryam Al-Nesf, Tayseer Ibrahim, Sami Aqel, Mona Al-Ahmad, Jean Bousquet","doi":"10.2147/JAA.S517784","DOIUrl":"10.2147/JAA.S517784","url":null,"abstract":"<p><p>Biologic therapies have revolutionized the management of severe asthma (SA), offering significant symptom control and reduced exacerbations for many patients. However, up to 25% of individuals do not show satisfactory responses to these treatments and are categorized as non-responders. Definitions of response and primary non-response to biologics in SA are well-established. In secondary nonresponse, patients show initial response to biological treatment in the first 6-12 months but later lose asthma control, and in SA this phenomenon remains undefined and unstudied in literature. We present 4 cases of severe asthma treated with different biologic agents. All patients demonstrated significant clinical improvement during the first 12 months of therapy but followed by a gradual loss of asthma control, indicative of secondary nonresponse. We discuss the clinical features, potential mechanisms, and implications of secondary nonresponse to biologics in severe asthma, highlighting an unmet need for further research to define this phenomenon and guide future therapeutic strategies.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"795-800"},"PeriodicalIF":3.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Age-Dependent Clinical Manifestations of Eosinophilic Gastrointestinal Disorders Beyond Eosinophilic Esophagitis.","authors":"Zhirong Du, Ji Li, Weixun Zhou, Yuxiang Zhi","doi":"10.2147/JAA.S510375","DOIUrl":"10.2147/JAA.S510375","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic gastrointestinal disorders (EGIDs) are chronic immune-mediated conditions characterized by pathological eosinophilic infiltration. The clinical features and therapies for eosinophilic esophagitis (EoE) vary between children and adults. However, there is limited comparison of non-EoE EGIDs across different ages of disease onset.</p><p><strong>Methods: </strong>We retrospectively analyzed data that included 94 patients (12 juveniles, 57 young adults, and 23 older adults) with a history of non-EoE EGIDs managed in a tertiary hospital.</p><p><strong>Results: </strong>The study included patients with a mean onset age of 36.6 years, 52.1% of whom had allergic comorbidities. Diarrhea was more common in young adults (18-49 years), while nausea and vomiting were predominant in juveniles (0-17 years) compared to older adults (≥50 years). Reduced flatulence and/or defecation were less common in young adults. Ascites were less frequent in older adults. Notably, patients with the same affected gastrointestinal site also exhibited varying manifestations across age groups: young adults with gastric or ileal involvement had higher diarrhea rates (64% and 68.4%, respectively, p < 0.05), while juveniles with gastric/duodenal involvement exhibited higher nausea, vomiting, and ascites, and those with ileal involvement showed higher ascites (p =0.031). Young adults with colonic involvement had reduced flatulence/defecation less frequently (p = 0.005). Juveniles had significantly higher peripheral eosinophil counts (p = 0.040), and higher total serum IgE levels (p =0.002) compared to older adults. Serum albumin levels were significantly higher, and erythrocyte sedimentation rate (ESR) was significantly lower in the juvenile group compared to the young adult group (p = 0.004, p = 0.045) and the older adult group (p = 0.002, p = 0.002).</p><p><strong>Conclusion: </strong>Clinical phenotypes of patients with non-EoE EGIDs vary by age of onset. A comprehensive understanding of the features in symptoms and therapies across different age groups can help accelerate diagnosis and enhance patient care.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"757-768"},"PeriodicalIF":3.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Treatment of Atopic Dermatitis with Upadacitinib in a Patient During Hepatitis C Activity Period.","authors":"Junke Huang, Mingyue Wang, Xing-Hua Gao, Li Zhang","doi":"10.2147/JAA.S527328","DOIUrl":"10.2147/JAA.S527328","url":null,"abstract":"<p><p>This case report aims to explore the efficacy and safety of upadacitinib in patients with severe atopic dermatitis during hepatitis C activity period, providing reference for the treatment of severe atopic dermatitis patients in clinical hepatitis C activity period. We reviewed the treatment history of a patient with severe atopic dermatitis with hepatitis C in our hospital and analysed the safety of applying upadacitinib for the treatment of severe atopic dermatitis in conjunction with the review of relevant literature. During the 1-year follow-up, the patient's peripheral rash gradually improved, and the hepatitis C viral RNA load was normalised at the 6-month follow-up, reaching the clinical criteria for hepatitis C cure. The patient took only oral triamcinolone and upadacitinib for half a year after hepatitis C cure, and no recurrence of hepatitis C or liver function abnormality was found. Upadacitinib can be considered as a treatment option for patients with severe atopic dermatitis during hepatitis C activity period, but more clinical cases and drug research are needed to assess its safety during hepatitis C activity period.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"753-756"},"PeriodicalIF":3.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Drew Davies, Joseph W Lanario, Michael E Hyland, Matthew Masoli
{"title":"Severe Asthma Questionnaire (SAQ) and Asthma Control Questionnaire (ACQ) as Early Predictors of Biologic Response in Severe Asthma.","authors":"Drew Davies, Joseph W Lanario, Michael E Hyland, Matthew Masoli","doi":"10.2147/JAA.S490267","DOIUrl":"https://doi.org/10.2147/JAA.S490267","url":null,"abstract":"<p><strong>Background: </strong>Biologic therapy in asthma can be life-changing and affect health-related quality of life, but symptoms are rarely used in the assessment of response.</p><p><strong>Aim: </strong>To examine the change in health-related quality of life and asthma control between starting a biologic and assessment of biologic response, assessing whether this change can provide early prediction of eventual clinical response at 12 months.</p><p><strong>Methods: </strong>A service evaluation of severe asthmatics initiating a biologic at the Royal Devon NHS trust between 2019 and 22. Health-Related Quality of Life (Severe Asthma Questionnaire) and asthma control (Asthma Control Questionnaire-6) was captured at baseline, 8 weeks, 16 weeks and 12 months. Patients were classified as responder or non-responder using NICE Criteria for biologic response. Independent samples <i>t</i>-tests were used to determine statistical difference in change from baseline patient reported outcome measure scores between responder and non-responders.</p><p><strong>Results: </strong>One hundred and eight initiations (103 patients) of biologic therapy were included. At 8 weeks and 16 weeks, responders had greater improvement in Severe Asthma Questionnaire & Severe Asthma Questionnaire Global compared to non-responders (p<0.05). Improvement in Asthma Control Questionnaire only achieved significance between all-responders and non-responders at 16 weeks (p<0.05).</p><p><strong>Conclusion: </strong>This study provides evidence of the early and sustained improvement in health-related quality of life and symptoms after starting biologic therapy. The findings support the use of the Severe Asthma Questionnaire and the Asthma Control Questionnaire as per the Core Outcome Measures Sets for Severe Asthma (COMSA). We have shown that health-related quality of life and asthma control can assist earlier assessment of response and non-response to biologics.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"743-752"},"PeriodicalIF":3.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nawaf Khalid Alqurashi, Syed Esam Mahmood, Abdullah Alsabaani, Ausaf Ahmad, Mohammad Suhail Khan, Ayed A Shati
{"title":"Cow's Milk Allergy and Associated Factors Among Children in Abha City, Saudi Arabia - A Retrospective Case Control Study.","authors":"Nawaf Khalid Alqurashi, Syed Esam Mahmood, Abdullah Alsabaani, Ausaf Ahmad, Mohammad Suhail Khan, Ayed A Shati","doi":"10.2147/JAA.S519523","DOIUrl":"https://doi.org/10.2147/JAA.S519523","url":null,"abstract":"<p><strong>Introduction: </strong>Cow's Milk Allergy (CMA) is the most common food allergy among children. The global prevalence of CMA ranges from 1.8% to 7.5% among children. Data regarding CMA is scarce and only a few studies have been conducted in Saudi Arabia. Therefore, this study was undertaken to determine the factors associated with CMA among children in Abha city and to explore the knowledge and practice regarding CMA among parents in Abha city.</p><p><strong>Methods: </strong>This retrospective one-year case control study was conducted amongst children with CMA (cases) and healthy children without CMA (controls) and their parents attending Abha Maternity and Children Hospital, Saudi Arabia. Data regarding CMA was extracted from the hospital medical records. A validated questionnaire was used to collect detailed information from the identified cases and controls after obtaining informed consent. SPSS software was used for data analysis.</p><p><strong>Results: </strong>The study groups consisted of 31 cases and 37 controls. Children between 0 and 36 months of age were included. The male-to-female ratio was 1:1. The parent's knowledge level was good regarding the association between early introduction of cow's milk and increased risk of CMA (Mean Score: 3.96). Having a sibling with a CMA is actually a risk factor for developing CMA (P-value = 0.03).</p><p><strong>Conclusion: </strong>To reduce the risk of CMA, the study recommends dietary strategies that exclude CMA allergens and the use of suitable alternative milk formulas. It highlights the protective role of breastfeeding and advises against the early introduction of cow's milk formulas during infancy. Furthermore, the study advocates for hospital nurseries and new parents to refrain from administering artificial milk formulas to newborns.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"723-742"},"PeriodicalIF":3.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yanni Chen, Chenfei Song, Jiaqin Wang, Yang Cao, Yueting Lu, Xinmin Han
{"title":"Knowledge Mapping of COVID-19 and Asthma/Allergic Rhinitis: A Visual and Bibliometric Analysis.","authors":"Yanni Chen, Chenfei Song, Jiaqin Wang, Yang Cao, Yueting Lu, Xinmin Han","doi":"10.2147/JAA.S512175","DOIUrl":"https://doi.org/10.2147/JAA.S512175","url":null,"abstract":"<p><strong>Objective: </strong>Numerous studies have highlighted a link between COVID-19 and respiratory allergic conditions such as asthma and allergic rhinitis (AR). Despite the growing volume of research, there remains a notable gap in the form of a comprehensive bibliometric analysis that consolidates the findings on this association. This study aims to fill that gap by systematically exploring how asthma and AR interact with COVID-19.</p><p><strong>Methods: </strong>By using the Web of Science Core Collection, we selected publications from January 2020 to October 2024 that related to COVID-19 and asthma/AR. Analysis tools such as VOSviewer and CiteSpace were employed to perform network mappings and citation analyses, focusing on co-authorship networks, keyword co-occurrences, and citation impacts to understand the research dynamics and collaborative patterns within this field.</p><p><strong>Results: </strong>A collection of 553 publications was obtained, revealing an upward trend in research volume over the study period. The United States, China, and the United Kingdom were predominant in the research output, demonstrating extensive international collaborations. The study highlighted key areas of impact, such as the influence of asthma types on COVID-19 severity and the protective effects of specific treatments like inhaled corticosteroids and biologics. Emerging trends identified included the significance of socioeconomic factors and obesity in disease outcomes, as well as evolving strategies in vaccination and interventions.</p><p><strong>Conclusion: </strong>This bibliometric analysis highlights the significant role of global research in exploring the interactions between COVID-19 and asthma/AR. It points out the reported safety and effectiveness of COVID-19 vaccines for these conditions and acknowledges the challenges in vaccine uptake among minority and socioeconomically disadvantaged groups. The study also identifies unique risks for children and obese patients during the pandemic and underscores the need for increased international collaboration and more comprehensive clinical trials, to evaluate the efficacy of treatments like inhaled corticosteroids and biologics.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"705-721"},"PeriodicalIF":3.7,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Riyad Al-Lehebi, Razan H Kharraz, Ohud Fahad Alreshidi
{"title":"The Impact of Biological Therapies and the Significance of Their Adherence on Asthma Outcomes in a Single Tertiary Asthma Center.","authors":"Riyad Al-Lehebi, Razan H Kharraz, Ohud Fahad Alreshidi","doi":"10.2147/JAA.S522414","DOIUrl":"https://doi.org/10.2147/JAA.S522414","url":null,"abstract":"<p><strong>Purpose and methods: </strong>Biological therapies have revolutionized the approach to treating asthma. This retrospective study evaluates the biologics impact on asthma outcomes, clinical remission, adherence prevalence, and the influence of adherence on outcomes. Baseline characteristics and post-therapy changes were analysed, and adherence was measured using percentage of days covered with therapy (PDC%).</p><p><strong>Results: </strong>A total of 67 patients initiated on biologics were included. Clinical improvements and statistically significant outcomes were observed across all biologics, including reduced asthma attacks, a lower dose of daily steroids, and improved symptom control and FEV1. Clinical remission was achieved in 24% of those who started on biologics. Patients demonstrated high adherence to biologics in the first year (average PDC% of 86%), though a modest decline to 84.5% was noted in the following year. Logistic regression revealed that adherence trends were not significantly associated with worsening asthma outcomes in the study cohort.</p><p><strong>Conclusion: </strong>These findings underscore the importance of sustained patient support and education in maintaining high adherence to biological therapies, which can lead to improved asthma outcomes and, in some cases, clinical remission. The study highlights the potential of personalized treatment strategies and adherence-focused programs to optimize asthma management, particularly in severe asthma patients. Future research should explore long-term adherence patterns and the impact of patient-specific factors on treatment success.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"695-704"},"PeriodicalIF":3.7,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marina Gueçamburu, Axelle Dupont, Bernice Djidonou, Charlotte Thibaut de Ménonville, Leyla Barakat, Félix Laborier, Mathilde Le Brun, Clairelyne Dupin, Catherine Neukirch, Camille Taillé
{"title":"Monosensitization vs Polysensitization in Severe Asthma: Implications for Disease Severity.","authors":"Marina Gueçamburu, Axelle Dupont, Bernice Djidonou, Charlotte Thibaut de Ménonville, Leyla Barakat, Félix Laborier, Mathilde Le Brun, Clairelyne Dupin, Catherine Neukirch, Camille Taillé","doi":"10.2147/JAA.S502442","DOIUrl":"https://doi.org/10.2147/JAA.S502442","url":null,"abstract":"<p><strong>Aim: </strong>The impact of sensitization on asthma outcomes in adults is still being discussed. This study aims to describe the sensitization profiles and allergic comorbidities of patients with severe asthma, and to analyze their association with asthma severity.</p><p><strong>Patients and methods: </strong>This retrospective study included adult patients, evaluated at the Severe Asthma Clinic of Bichat University Hospital (Paris, France) during a 1-day hospital stay between May 2022 and January 2024. Sensitization, defined by a positive skin prick test and/or allergen-specific IgE levels greater than 0.10 kUA/L, was analysed alongside allergic comorbidities. The ASSESS score was used to grade asthma severity.</p><p><strong>Results: </strong>Of the 201 patients included, 142 (70.6%) exhibited at least one sensitization to an aeroallergen, of whom 38 (26.8%) were monosensitized, and 104 (73.2%) were polysensitized. Compared to polysensitized patients, monosensitized patients were older at diagnosis (years: 30.6 ± 20.1 vs 21.7 ± 17.6, p = 0.01), had a higher ASSESS score (median (Q1; Q3); 13 (11; 15) vs 11 (9; 14), p = 0.02), a lower pre-bronchodilator forced expiratory volume in 1 second (%pred: 70.3 ± 23.2 vs 79.3 ± 21.8, p = 0.03), and experienced a greater burden of exacerbations (p = 0.03). There were significantly more polysensitized patients with at least three allergic comorbidities, but the number of allergic comorbidities did not correlate with asthma severity.</p><p><strong>Conclusion: </strong>Monosensitized patients exhibited more severe disease and greater airway obstruction compared to polysensitized individuals. These findings suggest that allergies, especially in cases of late-onset asthma, may not be a significant determinant of asthma severity in adults.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"683-694"},"PeriodicalIF":3.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pan Wang, Zheng Su, Chen Sun, Wen-Hui Yao, Yue-Ping Zeng
{"title":"The Role of Basophils in Atopic Dermatitis, from Pathogenesis to Therapeutic Perspectives.","authors":"Pan Wang, Zheng Su, Chen Sun, Wen-Hui Yao, Yue-Ping Zeng","doi":"10.2147/JAA.S522343","DOIUrl":"https://doi.org/10.2147/JAA.S522343","url":null,"abstract":"<p><p>Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by intense pruritus. The principal pathological features include abnormalities in the structure and function of the epidermis, as well as skin inflammation marked by the overexpression of T helper 2 cell (Th2) cytokines. Throughout the progression of AD, various immune cells contribute to its pathogenesis. Basophils, the least abundant granulocytes in the human peripheral circulation, have historically been overlooked. However, the advent of novel research tools has facilitated a renewed focus on the role of basophils in diverse physiological and pathological conditions, including AD. Accordingly, this review will primarily summarize the association between AD and basophils, the alterations observed in basophils among AD patients, and the implications of these changes for AD patients.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"675-682"},"PeriodicalIF":3.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hanyue Zhang, Pan Jiang, Sibin Mei, Ne Lin, Yanfei Fang, Qian Cao
{"title":"Carbamazepine-Induced DRESS Complicated by HLH and VBDS: A Case Report.","authors":"Hanyue Zhang, Pan Jiang, Sibin Mei, Ne Lin, Yanfei Fang, Qian Cao","doi":"10.2147/JAA.S505666","DOIUrl":"https://doi.org/10.2147/JAA.S505666","url":null,"abstract":"<p><strong>Background: </strong>Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe systemic disorder characterized by fever, rash, and multi-organ involvement, often complicated by drug-induced liver injury. Hemophagocytic lymphohistiocytosis (HLH) and vanishing bile duct syndrome (VBDS) are rare but life-threatening complications that can be triggered by antiepileptic drugs such as carbamazepine. Given the high mortality associated with these conditions, early recognition and timely intervention are crucial for improving patient outcomes.</p><p><strong>Case: </strong>We report a unique case of an elderly woman who developed DRESS syndrome after using carbamazepine, complicated by both HLH and VBDS. The patient exhibited typical DRESS symptoms, including fever, rash, and eosinophilia, alongside signs of HLH such as hemocytopenia and elevated ferritin levels; along with persistent significant hyperbilirubinemia and coagulation abnormalities.</p><p><strong>Results: </strong>After six months, liver function showed substantial improvement, with no signs of HLH recurrence. Additionally, our review of HLH cases induced by antiepileptic drugs highlights that the absence of eosinophilia, hemocytopenia, and elevated ferritin levels is key for early HLH identification.</p><p><strong>Conclusion: </strong>Our findings highlight key diagnostic indicators for early HLH recognition in antiepileptic drug-induced DRESS, especially the absence of eosinophilia. This case represents the first successful management of DRESS syndrome complicated by HLH and VBDS without liver transplantation in the past decade, emphasizing the critical role of early identification and prompt, targeted treatment strategies in optimizing patient outcomes.</p>","PeriodicalId":15079,"journal":{"name":"Journal of Asthma and Allergy","volume":"18 ","pages":"655-664"},"PeriodicalIF":3.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}