DRESS syndrome: a detailed insight

Behera, Sapan Kumar; Das, Saibal; Xavier, Alphienes Stanley; Selvarajan, Sandhiya

doi:10.1080/21548331.2018.1451205

Cited by 46 publications

(79 citation statements)

References 140 publications

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“…We consider the cutaneous adverse reaction after therapy with anakinra ( Figure 1L) rather as generalized drug eruption than as drug rash with eosinophilia and systemic symptoms (DRESS) syndrome. DRESS syndrome is a rare, severe multiorgan and potentially fatal systemic hypersensitivity reaction mostly caused by a limited number of eliciting drugs, especially anti-convulsants and antibiotics (16)(17)(18)(19)(20). A DRESS syndrome was also described in a child following treatment with anakinra (20).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Adult Still’s Disease in an Alemtuzumab-Treated Multiple Sclerosis Patient

et al. 2020

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Background: Autoimmune adverse events are the most relevant risks of alemtuzumab therapy. We present a patient with relapsing-remitting multiple sclerosis, who developed adult-onset Still's disease (AOSD) following alemtuzumab treatment. Case Presentation: The patient suffered from sore throat, swallowing difficulties, high spiking quotidian fever, generalized skin rash, arthritis, and myalgia 2 months after the second course of alemtuzumab. Laboratory tests revealed elevated acute-phase reactants, anemia, neutrophilic leukocytosis, and thrombocytosis. Serum calprotectin, interleukin-2, and interleukin-6 levels were strongly increased. Autoimmune, rheumatic, neoplastic, infectious, and granulomatous disorders were excluded. The NLRP1 and NLRP3 gene test, which was performed under the presumption of a cryopyrinassociated autoinflammatory syndrome, was negative. Based on the Yamaguchi and Fautrel criteria, and supported by the histological findings from a skin biopsy of the rash, the diagnosis of AOSD was established. Therapy with the anti-IL-1 agent (anakinra) led to a significant improvement of symptoms and blood parameters. However, anakinra had to be converted to rituximab due to generalized drug eruption. Following therapy with rituximab, the patient has fully recovered. Conclusion: The current case highlights AOSD as another rare and potentially life-threatening secondary autoinflammatory/autoimmune event following alemtuzumab treatment.

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Section: Discussionmentioning

confidence: 99%

Case Report: Adult Still’s Disease in an Alemtuzumab-Treated Multiple Sclerosis Patient

et al. 2020

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“…Dress syndrome is a severe drug reaction that involves the skin as well as organs. Differential diagnoses could include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP), all of which are considered severe cutaneous adverse reactions (SCARs) to medications [4].…”

Section: Discussionmentioning

confidence: 99%

Vancomycin-Induced Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Masquerading as Elusive Sepsis

Roy

Goswamy

Barssoum

et al. 2019

Case Reports in Immunology

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We present a unique case of vancomycin-induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome masquerading as elusive endocarditis. A 37-year-old female actively using intravenous drugs presented with worsening right upper extremity pain, fever, and chills. Workup revealed methicillin-resistant staphylococcus aureus (MRSA) bacteremia and multiple right-sided septic pulmonary emboli. Echocardiogram was negative for vegetation. Vancomycin was initiated for bacteremia management suspected secondary to right upper extremity abscesses. However, despite resolution of abscesses, fevers persisted, raising suspicion for endocarditis not detected by echocardiogram. On hospital day 25, the patient began showing signs of DRESS syndrome, ultimately manifesting as transaminitis, eosinophilia, and a diffuse, maculopapular rash. Vancomycin was switched to Linezolid and she improved on high dose steroids. The persistent fevers throughout this hospital course were thought to be an elusive endocarditis before DRESS syndrome fully manifested. Although Vancomycin-induced DRESS is uncommon, this case highlights the importance of identifying early signs of significant adverse effects.

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“…Currently, the scoring system proposed by the Registry of Severe Cutaneous Adverse Reactions offers diagnostic criteria for hospitalized patients with a drug associated rash. The system allows classification for suspected clinical cases as excluded, possible, probable or definite for DRESS ( Table 2 ) [2 , [4] , [5] , [6] .…”

Section: Introductionmentioning

confidence: 99%

Drug reaction with eosinophilia and systemic symptoms (DRESS) with severe and atypical lung involvement

Gómez

Zorro

Barrios

et al. 2020

Radiology Case Reports

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Drug reaction with eosinophilia and systemic symptoms is a rare and potentially fatal drug hypersensitivity reaction. Reactions include skin eruption, fever, hematologic abnormalities (eosinophilia or atypical lymphocytosis), enlarged lymph nodes, and/or organic involvement. The liver is the most commonly compromised organ. We present a case of drug reaction with eosinophilia and systemic symptoms associated with Naproxen intake in a young female patient with severe lung involvement. The patient's chest tomography highlights the presence of adenomegalies, pericardial and pleural effusion, peribroncovascular consolidations, and centrilobular nodules. After reviewing the literature few similar cases were found. The main radiological alterations in those cases included interstitial opacities attributed to pneumonitis. Therefore, this case study is considered an unusual case with atypical presentation of drug-induced eosinophilic lung disease.

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DRESS syndrome: a detailed insight

Cited by 46 publications

References 140 publications

Case Report: Adult Still’s Disease in an Alemtuzumab-Treated Multiple Sclerosis Patient

Case Report: Adult Still’s Disease in an Alemtuzumab-Treated Multiple Sclerosis Patient

Vancomycin-Induced Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Masquerading as Elusive Sepsis

Drug reaction with eosinophilia and systemic symptoms (DRESS) with severe and atypical lung involvement

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