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Many clinics exclude this group

In a follow-up study, homocysteine and GPx1 were the strongest predictors of future cardiovascular event risk, and those with low GPx-1 activity had a nearly 3-fold increase in risk if they also had homocysteine levels above the median [87]

however, some authors perform these tests to improve the accuracy in identifyng the medication that triggers DRESS, considering them potentially useful and safe when performed by specialists.58,62 It should be noted that, despite the small doses used, at concentrations lower than in patch testing, serious and even fatal reactions have occurred and European guidelines still contraindicate it.63 Therefore, the indication of IDT must be carefully evaluated and is of great importance in reactions caused by antibiotics, due to the possibility of cross-reaction between them.58,62 Certain precautions are important when carrying out IDT in patients with DRESS: i) Tests with medications must be carried out in a hospital environment (under supervision) and can only be carried out with commercially available drugs in injectable form