Liver transplantation after DRESS syndrome: A case report and review of the literature

Calil, Igor Lepski; Tustumi, Francisco; Pinheiro, Rafael Soares; Tanigawa, Ryan; Cruz, Ruy J.; Sousa, Jorge Henrique Bento de; Pecora, Rafael Antônio Arruda; D’Albuquerque, Luiz Augusto Carneiro

doi:10.1002/ccr3.3334

Cited by 5 publications

(5 citation statements)

References 37 publications

(50 reference statements)

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“…Our literature review detected 15 cases of sulfasalazine-induced hypersensitivity syndrome in children aged 10-18 years (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Sulfasalazine in children was used mainly for a group of related diseases with strong male predisposal, including inflammatory bowel disease (IBD), psoriasis, and enthesitis-related arthritis (ERA).…”

Section: Resultsmentioning

confidence: 99%

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Case report: Sulfasalazine-induced hypersensitivity

2023

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Drug-induced hypersensitivity syndrome (DiHS)/drug reaction with eosinophilia and systemic symptoms (DRESS) is a systemic inflammatory condition that is characterized by multisystemic involvement (liver, blood, and skin), heterogeneous manifestations (fever, rash, lymphadenopathy, and eosinophilia), and an unpredictable course; cases of DiHS/DRESS caused by sulfasalazine are rare in children compared to adults. We report a case of a 12-year-old girl with juvenile idiopathic arthritis (JIA) and sulfasalazine-related hypersensitivity who developed fever, rash, blood abnormalities, and hepatitis complicated with hypocoagulation. The treatment with intravenous and then oral glucocorticosteroids was effective. We also reviewed 15 cases (67% male patients) of childhood-onset sulfasalazine-related DiHS/DRESS from the MEDLINE/PubMed and Scopus online databases. All reviewed cases had a fever, lymphadenopathy, and liver involvement. Eosinophilia was reported in 60% of patients. All patients were treated with systemic corticosteroids, and one patient required emergency liver transplantation. Two patients (13%) died. A total of 40.0% of patients satisfied RegiSCAR definite criteria, 53.3% were probable, and 80.0% satisfied Bocquet's criteria. Only 13.3% satisfied typical and 20.0% atypical DIHS criteria from the Japanese group. Pediatric rheumatologists should be aware of DiHS/DRESS due to its similarities to other systemic inflammatory syndromes (especially systemic JIA, macrophage activation syndrome, and secondary hemophagocytic lymphohistiocytosis). Further studies of DiHS/DRESS syndrome in children are needed to improve its recognition and differential diagnostic and therapeutic options.

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Section: Resultsmentioning

confidence: 99%

“…The standard form of extracted data contained the author, initial diagnosis, sex, age, clinical symptoms, laboratory results, therapy, and follow-up (Table 1) (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19).…”

Section: Search Strategymentioning

confidence: 99%

Case report: Sulfasalazine-induced hypersensitivity

2023

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“…The level of liver enzymes significantly increased in DRESS syndrome. 10 The life-threatening effects of DRESS syndrome on liver are also observed as reported recently by Calil et al; 11 however, these effects are quite rare.…”

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confidence: 63%

Identification of novel signal of clobazam‐associated drug reaction with eosinophilia and systemic symptoms syndrome: A disproportionality analysis

Sharma

Kumar

2022

Acta Neuro Scandinavica

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Clobazam is a benzodiazepine class medication, used for its anxiolytic effect, as well as an adjunctive therapy in epilepsy for patients who have not responded to first-line treatments and in children who are refractory to first-line drugs. 1,2 It acts on the benzodiazepine binding site of Gamma-aminobutyric acid A (GABA-A) receptor complex which results in hyperpolarization through the increased opening frequency of the ligand-gated chloride-ion channel. 3

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“…Aggressive treatment may be required in severe liver failure; however, a treatment strategy for this situation has not yet been established ( 9 ). Although few patients undergo liver transplantation, the prognosis of this syndrome is poor, with a relatively high mortality rate (approximately 50%) ( 10 ). Furthermore, a case of fulminant liver failure due to recurrence of DRESS following liver transplantation has been reported ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

Atypical, Levetiracetam-induced Hypersensitivity Syndrome Complicated by Fulminant Liver Failure in a Patient Undergoing Hemodialysis

et al. 2022

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A 59-year-old man undergoing hemodialysis was administered levetiracetam, after which he developed a systemic rash, high fever, severe liver dysfunction, and leukocytopenia with reactivation of human herpes virus 6. Atypical drug-induced hypersensitivity (DIHS) was diagnosed, and prednisolone was administered at 60 mg/day. However, liver failure rapidly progressed, and the patient died 12 days following treatment. Despite the rarity of DIHS with concomitant fulminant liver failure from levetiracetam and sufficient clearance thereof by hemodialysis, our case suggests that this syndrome may still ensue, resulting in mortality, even in hemodialysis patients. Although no treatment has yet been established, strict monitoring and aggressive treatment may be required.

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Liver transplantation after DRESS syndrome: A case report and review of the literature

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 5 publications

References 37 publications

Case report: Sulfasalazine-induced hypersensitivity

Case report: Sulfasalazine-induced hypersensitivity

Identification of novel signal of clobazam‐associated drug reaction with eosinophilia and systemic symptoms syndrome: A disproportionality analysis

Atypical, Levetiracetam-induced Hypersensitivity Syndrome Complicated by Fulminant Liver Failure in a Patient Undergoing Hemodialysis

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