Sulfasalazine-induced DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms)

Abstract

CONTEXT: DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is a type of drug reaction commonly mistaken for a viral infection. It must be recognized promptly due to its high morbidity and 10% mortality rate. Few cases of DRESS syndrome induced by sulfasalazine have been reported in the literature. CASE REPORT: The case of a 47-year-old white Brazilian woman who developed DRESS syndrome eight weeks after starting a course of sulfasalazine for treatment of seronegative arthritis is reported. She presented a skin rash, fever, hepatitis, lymphadenopathy, eosinophilia and atypical lymphocytes. The causative drug was discontinued immediately, but she only improved after treatment with prednisone.

HLA-B*13:01 Is Associated with Salazosulfapyridine-Induced Drug Rash with Eosinophilia and Systemic Symptoms in Chinese Han Population

“…This high incidence of females in SASP-induced DRESS was consistent with the sex distribution in previously reported cases. We reviewed future science group HLA-B*13:01 associated with salazosulfapyridine-induced drug rash with eosinophilia in Chinese Han population Research Article 15 SASP-induced DRESS patients without viral eruption from 2001 to 2013 [8][9][10][29][30][31][32][33][34][35][36][37][38]. Among them, 13 were females.…”

“…It is characterized by multisystemic involvement, frequent eosinophilia and cutaneous eruptions, with a mortality rate of approximately 10% [5][6][7]. SASP-induced DRESS has been frequently reported [8][9][10]. Therefore, it is important to clarify the pathogenic mechanism and determine biomarkers for the prediction of the risk of SASP-induced DRESS before administering medication.…”

DRESS Syndrome Induced by Sulfasalazine with Amoxicillin: Case Report

“…Sülfasalazin, nonsteroid antiinflamatuar, antiviral ilaçlar (telaprevir) ve tüberküloz tedavisinde kullanılan ilaç-lar bunlar arasındadır. [1][2][3][4][5][6][7][8][9][10][11] Yang ve ark., antikonvülzan ilaçlardan karbamazebin ve fenitoinin tüm DRESS sendromu vakalarının %43,6'sından sorumlu olduğunu bildirmişlerdir. 7 Farklı genetik ve etnik predispozisyon nedeni ile dünyanın farklı coğrafi bölgelerinde farklı ilaçlar ön plana çıkabil-mektedir.…”

“…Ancak, üst solunum yolu enfeksiyonu semptomları nedeni ile reçete edilen bu antibiyotiğin aslında, DRESS sendromunun erken dönem bulgularının yanlış tanımlanması ile yazılmış olabileceği olasılığı da aydınlatılmayı bekleyen bir tartışma konusudur. 3,9 Tedavide; şüpheli ilacın/ilaçların kesilmesi, sistemik ve topikal kortikoid tedavisi ve semptomlara yönelik destek tedavi başlıca tedavi yönetimini oluşturmaktadır. Kortikoidlerin, sendromun gelişimine neden olan eozinofillerin birikimi üzerine interlökinlerin etkisini engelleyerek etki ettiği dü-şünülmektedir.…”

The Use of Sulfasalazine in Severe Types of Alopecia Areata

“…These include the "three-week syndrome", which is characterized by fever, lymphadenopathy and widespread erythematous rash, followed by severe hepatotoxicity [40]. The more serious reaction, DRESS syndrome, does not occur frequently, however, physicians should perform a close observation especially during the early phase of therapy [40,41].…”