DRESS Syndrome: a Case Report and Literature Review

Overview

Journal BMJ Case Rep

Specialty General Medicine

Date 2012 Jun 14

PMID 22693316

Citations 15

Authors

Claudia Sofia Cardoso

Ana Margarida Vieira

Ana Paula Oliveira

Affiliations

Soon will be listed here.

Abstract

DRESS syndrome (drug rash, eosinophilia and systemic symptoms) is an idiosyncratic drug reaction characterised by rash, fever, lymphadenopathy and internal organ involvement. The authors report a case of this syndrome presenting with fever, generalised pruritus, macular rash and cholestatic hepatitis during allopurinol treatment. This case resolved with drug withdrawal, but the death rate in the setting of hepatic failure can reach 10%. Rapid diagnosis is crucial as prompt withdrawal of the offending drug is the key of the treatment, while the potential role of corticosteroids remains controversial.

Citing Articles

Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome: A Case Report From South India.

Sahukar S, Chandrappa Byranahalli V Cureus. 2024; 16(7):e65128.

PMID: 39171055 PMC: 11338584. DOI: 10.7759/cureus.65128.

Fatal Itching and Failing Liver: A Case Report and Literature Review of Rare, Atypical DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) Syndrome.

Abusuliman M, Amreia M, Rehman S, Chaudhary A, Abosheaishaa H, Jamali T Cureus. 2024; 16(3):e55355.

PMID: 38559511 PMC: 10981999. DOI: 10.7759/cureus.55355.

Hepatic Safety of Febuxostat and Allopurinol for Gout Patients: A Systematic Review of Randomized Controlled Trial.

Dewi C, Puspita F, Puspitasari I, Zakiyah N Ther Clin Risk Manag. 2023; 19:731-743.

PMID: 37744559 PMC: 10516211. DOI: 10.2147/TCRM.S424598.

COVID-19 Vaccine: A Common Suspect but Rare Culprit in Drug Rash With Eosinophilia and Systemic Symptoms (DRESS) Syndrome.

Hanna M, Yang S Cureus. 2022; 14(11):e31310.

PMID: 36514624 PMC: 9735271. DOI: 10.7759/cureus.31310.

A typical presentation of moxifloxacin-induced DRESS syndrome with pulmonary involvement: a case report and review of the literature.

Zhang Y, Wang X, Cheng Y, Wang X, Zhang Y BMC Pulm Med. 2022; 22(1):279.

PMID: 35854287 PMC: 9297593. DOI: 10.1186/s12890-022-02064-1.

References

Shalom R, Rimbroth S, Rozenman D, Markel A . Allopurinol-induced recurrent DRESS syndrome: pathophysiology and treatment. Ren Fail. 2008; 30(3):327-9. DOI: 10.1080/08860220701861045. View

Sullivan J, Shear N . The drug hypersensitivity syndrome: what is the pathogenesis?. Arch Dermatol. 2001; 137(3):357-64. View

Roujeau J . Treatment of severe drug eruptions. J Dermatol. 2000; 26(11):718-22. DOI: 10.1111/j.1346-8138.1999.tb02082.x. View

Callot V, Roujeau J, Bagot M, Wechsler J, Chosidow O, Souteyrand P . Drug-induced pseudolymphoma and hypersensitivity syndrome. Two different clinical entities. Arch Dermatol. 1996; 132(11):1315-21. View

Hellman C, Lonnkvist K, Hedlin G, Hallden G, Lundahl J . Down-regulated IL-5 receptor expression on peripheral blood eosinophils from budesonide-treated children with asthma. Allergy. 2002; 57(4):323-8. DOI: 10.1034/j.1398-9995.2002.1o3482.x. View

Pichler W, Tilch J . The lymphocyte transformation test in the diagnosis of drug hypersensitivity. Allergy. 2004; 59(8):809-20. DOI: 10.1111/j.1398-9995.2004.00547.x. View

Roujeau J . Clinical heterogeneity of drug hypersensitivity. Toxicology. 2005; 209(2):123-9. DOI: 10.1016/j.tox.2004.12.022. View

Yamaguchi M, Ohta A, Tsunematsu T, Kasukawa R, Mizushima Y, Kashiwagi H . Preliminary criteria for classification of adult Still's disease. J Rheumatol. 1992; 19(3):424-30. View

Begon E, Roujeau J . [Drug hypersensitivity syndrome: DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms)]. Ann Dermatol Venereol. 2004; 131(3):293-7. DOI: 10.1016/s0151-9638(04)93600-9. View

10.

Tas S, Simonart T . Drug rash with eosinophilia and systemic symptoms (DRESS syndrome). Acta Clin Belg. 1999; 54(4):197-200. View

11.

De Vriese A, Philippe J, Van Renterghem D, De Cuyper C, Hindryckx P, Matthys E . Carbamazepine hypersensitivity syndrome: report of 4 cases and review of the literature. Medicine (Baltimore). 1995; 74(3):144-51. DOI: 10.1097/00005792-199505000-00004. View

12.

Mona Ben Mrad , Leclerc-Mercier S, Blanche P, Franck N, Rozenberg F, Fulla Y . Drug-induced hypersensitivity syndrome: clinical and biologic disease patterns in 24 patients. Medicine (Baltimore). 2009; 88(3):131-140. DOI: 10.1097/MD.0b013e3181a4d1a1. View

13.

Saltzstein S, ACKERMAN L . Lymphadenopathy induced by anticonvulsant drugs and mimicking clinically pathologically malignant lymphomas. Cancer. 1959; 12(1):164-82. DOI: 10.1002/1097-0142(195901/02)12:1<164::aid-cncr2820120122>3.0.co;2-y. View

14.

Gupta A, Eggo M, Uetrecht J, Cribb A, Daneman D, Rieder M . Drug-induced hypothyroidism: the thyroid as a target organ in hypersensitivity reactions to anticonvulsants and sulfonamides. Clin Pharmacol Ther. 1992; 51(1):56-67. DOI: 10.1038/clpt.1992.8. View

15.

Michel F, Navellou J, Ferraud D, Toussirot E, Wendling D . DRESS syndrome in a patient on sulfasalazine for rheumatoid arthritis. Joint Bone Spine. 2005; 72(1):82-5. DOI: 10.1016/j.jbspin.2004.06.002. View

16.

Chopra S, Levell N, Cowley G, Gilkes J . Systemic corticosteroids in the phenytoin hypersensitivity syndrome. Br J Dermatol. 1996; 134(6):1109-12. View

17.

Knowles S, Shapiro L, Shear N . Serious dermatologic reactions in children. Curr Opin Pediatr. 1997; 9(4):388-95. DOI: 10.1097/00008480-199708000-00014. View