A Young Child with Eosinophilia, Rash, and Multisystem Illness: Drug Rash, Eosinophilia, and Systemic Symptoms Syndrome After Receipt of Fluoxetine

Vignesh, Pandiarajan; Kishore, Janak; Kumar, Ankur; Vinay, Keshavamurthy; Dogra, Sunil; Sreedharanunni, Sreejesh; Giri, Prabhas Prasun; Pal, Priyankar; Ghosh, Apurba

doi:10.1111/pde.13131

Cited by 9 publications

(8 citation statements)

References 9 publications

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“…Mechanism is mostly due to immune complex mediated, but B19V may directly infect endothelial cells as well as fibroblasts in the skin with enhanced tumour necrosis factor (TNF)-alpha expression and vascular deposition of C5b-9 in the endothelial cells besides neoantigenicityand cell injury as seen in scleroderma94. Recently, we reported a four year old child with drug rash and eosinophilia with systemic symptoms syndrome on fluoxetine and complicated by B19V infection36.…”

Section: Multiorgan Afflictions By Human Parvovirus B19 (B19v) and Itmentioning

confidence: 99%

Clinical impact & pathogenic mechanisms of human parvovirus B19: A multiorgan disease inflictor incognito

Kishore

2018

Indian J Med Res

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Human parvovirus B19 (B19V) causes myriads of clinical diseases; however, owing to lack of awareness and undetermined clinical impact, it has failed to become a virus pathogen of global concern. Cryptically, B19V causes significant morbidity and mortality. Half of the world population and 60 per cent of Indians are known to be serologically naive and are at risk of acquiring B19V infections. Cumulatively, our data showed 21.3 per cent B19V-infected patients with juvenile chronic arthropathy, recurrent abortions, multi-transfused thalassaemia and leukaemia. In addition, B19V-infected cases that ended fatally included patients with pure red cell aplasia, fulminant hepatitis and haemophagocytic syndrome. Novel clinical associations of B19V observed were amegakaryocytic thrombocytopaenia, myositis and non-occlusive ischaemic gangrene of bowel. B19V possesses multiple receptors which are distributed widely in human tissues. Vascular endothelial cell infection by B19V causes endothelialitis and vasculitic injuries besides antibody-dependent enhancement which empowered B19V to cause multiorgan diseases. Owing to lack of suitable animal model for B19V, true causal role remains to be determined, but numerous reports on B19V infections substantiate a causal role in multiorgan diseases. Hence, B19V infections need to be recognized, investigated and treated besides making efforts on vaccine developments.

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Section: Multiorgan Afflictions By Human Parvovirus B19 (B19v) and Itmentioning

confidence: 99%

Clinical impact & pathogenic mechanisms of human parvovirus B19: A multiorgan disease inflictor incognito

Kishore

2018

Indian J Med Res

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“…The most commonly implicated drugs in children include antibiotics, namely trimethoprim‐sulfamethoxazole and vancomycin, followed by antiepileptic medications, such as lamotrigine, carbamazepine, and phenytoin . Ibuprofen, nevirapine, raltegravir, acetylsalicylic acid, griseofulvin, fluoxetine, and sulthiamine have been associated triggers in single pediatric case reports . In addition, Sasidharanpillai et al found DRESS to occur more promptly after antibiotic therapy, averaging about one week after drug initiation, compared to over three weeks after antiepileptic therapy …”

Section: Introductionmentioning

confidence: 99%

“…[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Ibuprofen, nevirapine, raltegravir, acetylsalicylic acid, griseofulvin, fluoxetine, and sulthiamine have been associated triggers in single pediatric case reports. 3,[26][27][28][29][30][31] In addition, Sasidharanpillai et al found DRESS to occur more promptly after antibiotic therapy, averaging about one week after drug initiation, compared to over three weeks after antiepileptic therapy. 9 Treatment of DRESS is prompt discontinuation of the culprit medication and initiation of systemic corticosteroids to reduce widespread inflammation.…”

Section: Introductionmentioning

confidence: 99%

Drug reaction with eosinophilia and systemic symptoms: Pediatric case series and literature review

Oberlin

Rahnama‐Moghadam

Alomari

et al. 2019

Pediatric Dermatology

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Background Pediatric Drug reaction with eosinophilia and systemic symptoms (DRESS) is an uncommon disease that can be difficult to diagnose. This case series and literature review highlights the clinical features of pediatric DRESS and underscores the differential diagnoses, culprit medications, and need for clinical follow‐up to detect associated autoimmune sequelae. Objective To describe the clinical and laboratory features of pediatric DRESS, identify associated culprit medications, and discuss the natural history of disease. Methods Ten cases of pediatric DRESS were identified in the electronic medical record by searching the inpatient dermatology consultation list at Indiana University between 2013 and 2018. Clinical and laboratory data were collected including demographics, differential diagnoses, culprit medications, resolution of disease, and autoimmune sequelae. Results Pediatric patients with DRESS presented at a mean age of 11.5 years and demonstrated a mean time from drug initiation to onset of symptoms of 4 weeks. The most common inciting drugs included antibiotics (62.5%) followed by antiepileptics (37.5%). Rash and transaminitis resolved by 3 weeks, and 20% of patients, all female, developed autoimmune sequelae including Hashimoto's thyroiditis and an undifferentiated connective tissue disorder and occurred at an average of 14.5 weeks after diagnosis. Limitations This was a small retrospective study of an uncommon clinical diagnosis at a single institution. Conclusions Pediatric DRESS was most commonly caused by antibiotics which are being increasingly recognized in the literature as the predominant culprit medications. The development of autoimmune sequelae is a notable consequence that can present weeks after illness and may preferentially affect female patients.

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“…In one case, it was reported to be related with a severe systemic hypersensitivity reaction including drug rash, eosinophilia, and systemic symptoms in a 4-year-old girl. 10 There is only one other case of angioedema accompanying urticaria and flu-like symptoms developing 2 days after ingestion of high dose fluoxetine. 5 The other case of angioedema attributed to treatment fluoxetine with 10 mg/day was without urticaria and thought to be a pseudoallergic reaction.…”

Section: Discussionmentioning

confidence: 99%

Angioedema and Urticaria Associated with Fluoxetine in a Preadolescent Boy

Adanır¹,

Önder²,

Soğucak³

et al. 2018

cayd

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A Young Child with Eosinophilia, Rash, and Multisystem Illness: Drug Rash, Eosinophilia, and Systemic Symptoms Syndrome After Receipt of Fluoxetine

Cited by 9 publications

References 9 publications

Clinical impact & pathogenic mechanisms of human parvovirus B19: A multiorgan disease inflictor incognito

Clinical impact & pathogenic mechanisms of human parvovirus B19: A multiorgan disease inflictor incognito

Drug reaction with eosinophilia and systemic symptoms: Pediatric case series and literature review

Angioedema and Urticaria Associated with Fluoxetine in a Preadolescent Boy

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