Abstract: Objective: To analyze the clinical characteristics of drug-induced hypersensitivity syndrome (DIHS) in children and to enhance clinicians' understanding of this condition. Methods: A retrospective descriptive analysis was conducted on the clinical features, auxiliary examinations, treatment decisions, and prognosis of 58 children with DIHS admitted to Xi'an Children's Hospital from January 2016 to December 2023. Results: Among the 58 children with DIHS, 30 were male and 28 were female, with a median age of 2.04 (IQR: 1.00, 4.29) years. A clear medication history was identified in 36 cases, while 22 cases involved mixed medication use. Among the cases with identified sensitizing drugs, the top three most common triggering drugs were antiepileptic drugs (20 cases, 34.5%), antibiotics (9 cases, 15.5%), and antipyretics/analgesics (4 cases, 6.9%). The mean latency period for DIHS was (20.84 ± 8.09) days in 30 cases. In addition to fever and rash, clinical manifestations included lymphadenopathy in 43 cases (74.1%), elevated transaminases in 53 cases (91.4%), myocardial injury in 46 cases (79.3%), and pulmonary involvement in 23 cases (39.7%). Leukocyte count exceeded 11×109/L in 53 cases (91.4%), atypical lymphocytes exceeded 5% in 39 cases (67.2%), and eosinophil count was elevated in 36 cases (62.1%). Seven cases (12.1%) were complicated by hemophagocytic syndrome. Active treatment involving intravenous glucocorticoids and/or intravenous immunoglobulin was administered, with severe cases additionally receiving blood purification and immunosuppressants. The mean hospital stay for the 58 patients was (17.67 ± 10.05) days. Clinical cure was achieved in 32 cases (55.2%), improvement in 24 cases (34.5%), and death occurred in 2 cases (3.4%). Conclusions: For cases presenting with recurrent fever, rash, lymphadenopathy, and poor response to conventional treatment, a detailed medication history within the past two months should be obtained to alert for the possibility of DIHS.

Key words: children, drug hypersensitivity syndrome, multiple organ dysfunction, clinical features