Yazicioglu, M.Ozdemir, P. GokmirzaTurgut, B.Sut, N.2024-06-122024-06-1220200301-05461578-1267https://doi.org/10.1016/j.aller.2019.02.003https://hdl.handle.net/20.500.14551/20599Background: Fatty acid synthetase (Fas)/Fas ligand (FasL)-dependent apoptotic pathways have been reported as being involved in the pathogenesis of drug-induced maculopapular rashes. Objective: We investigated serum soluble FasL (sFasL) levels and peripheral blood lymphocyte subtypes to discriminate maculopapular drug eruptions (MPDE) from viral exanthema (VE). Patients/methods: Children with confirmed MPDE (group I), VE (group II), and drug rashes with eosinophilia and systemic symptoms (DRESS) or drug-induced hypersensitivity syndrome (DIHS) (group III) were included. Serum sFasL levels and peripheral blood lymphocyte subtypes were analyzed in groups I- III on admission, and repeated twice (only once for group IV-controls). Results: There were no significant serum soluble FasL level differences among the groups for all the samples. In the initial samples, CD19(+) cell numbers in group II were significantly higher than in group IV, and the CD4(+) /CD8(+) ratio was higher than groups I and IV. In the second samples, CD4(+) and CD19(+) cell numbers were significantly higher in group II than group I. In the final samples, CD4(+) cell numbers in group II were significantly higher than group I and group III. CD19(+) cells numbers in group III were significantly lower than the other groups for all samples. Conclusion: Serum sFasL levels were not found to be useful in discriminating viral exanthemas from other drug rashes. The significant differences between MPDE, VE, and DRESS were high CD4(+) and CD19(+) cell-count numbers in VE but low B-cell numbers in DRESS. This might be important for discriminating VE from DRESS, and the low B-cell count in early symptoms might be a useful predictor of DRESS development. (C) 2019 SEICAP. Published by Elsevier Espana, S.L.U. All rights reserved.en10.1016/j.aller.2019.02.003info:eu-repo/semantics/closedAccessDrug-Induced Maculopapular RashesDIHSDRESSViral ExanthemasSoluble Fas LigandLymphocyte SubpopulationsToxic Epidermal NecrolysisStevens-Johnson-SyndromeHuman-Herpesvirus-6 ReactivationAllergic ReactionsProvocation TestsDelayed-ReactionsAssociationDiagnosisCellsArticle484339347Q4WOS:0005469771000052-s2.0-8506985624231375337Q3