Updates and Insights in the Diagnosis and Management of DRESS Syndrome

Schunkert, Elisa Maria; Divito, Sherrie J.

doi:10.1007/s13671-021-00348-z

Cited by 39 publications

(83 citation statements)

References 89 publications

(93 reference statements)

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“…Potentially all drugs can cause this syndrome, but the most frequent are aromatic anticonvulsivants and allopurinol 9 , a fact that has also emerged from one of our recent studies 10 . However, the literature also describes rare cases associated with vaccinations, which have a shorter onset latency than other drugs 5 .…”

Section: Discussionmentioning

confidence: 90%

A definite case of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) induced by administration of the Pfizer/BioNTech BNT162b2 vaccine for SARS-CoV2

Schroeder,

Gamba,

Toniato

et al. 2022

Clinics in Dermatology

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Section: Discussionmentioning

confidence: 90%

A definite case of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) induced by administration of the Pfizer/BioNTech BNT162b2 vaccine for SARS-CoV2

Schroeder,

Gamba,

Toniato

et al. 2022

Clinics in Dermatology

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“…DRESS is a potentially life-threatening drug-induced reaction ( Cacoub et al, 2011 ). Clinically, it is classically characterized by a cutaneous eruption, fever, lymphadenopathy, eosinophilia, and visceral involvement ( Schunkert & Divito, 2021 ) associated with a latency of 11 to 35 days post-stimulus ( Wolfson et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Severe Acute Interstitial Nephritis, Dermatitis, and Hemolytic Anemia due to Polyparasitic Infection in an Immunocompetent Male Patient

et al. 2022

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Acute interstitial nephritis (AIN) is a relevant cause of acute renal failure. Drugs are the predominant cause, followed by infections and idiopathic lesions. AIN, as a form of hypersensitivity reaction, is an uncommon manifestation in the setting of human parasitic infections. We report a case of a polyparasitic infection ( Giardia lamblia, Entamoeba coli, and Endolimax nana) resulting in a severe biopsy-proven AIN in a 61-year-old male patient. Despite the antiparasitic treatment followed by corticosteroid therapy, and during the 6-month follow-up period, the patient remained dialysis-dependent, and he developed autoimmune hemolytic anemia. Extensive search for another infection or neoplasia was negative. Immunological tests were also negative. The resulting hypersensitivity reaction to the triple parasite infection would have led to fatal evolution for the kidneys affected by this unusual type of AIN.

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“…The average time to recovery is six to nine weeks and most patients do well. Routine follow-up is recommended for about two years since some patients can suffer long-term organ dysfunction or develop autoimmune diseases [11,12] Although adverse events from vaccines are rare, there are a few case reports of DRESS syndrome that could have been potentially triggered by vaccines including the COVID-19 vaccine [13][14][15]. In the setting of a recent viral pandemic and strong anti-science and anti-vaccine sentiment, the COVID-19 vaccine has become a convenient target for a variety of side effects, symptoms, and diseases to attribute to.…”

Section: Discussionmentioning

confidence: 99%

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

Hanna¹,

Yang²

2022

Cureus

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Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare drug reaction that commonly presents with rash, fever, lymphadenopathy, eosinophilia, and multiorgan involvement. We present a case of this syndrome in a 31-year-old male who presented with a diffuse erythematous morbilliform rash with high fever and elevated liver enzymes. Upon history taking, the patient reported acute onset of multiple seizures that required intubation and ICU admission six weeks prior, which started 24 hours after receiving the Johnson and Johnson Janssen coronavirus disease 2019 (COVID-19) vaccine. During that hospitalization, he was given antiseizure medications Keppra (levetiracetam) and Dilantin (phenytoin), which he was eventually discharged home with. During our encounter with the patient, Dermatology was consulted and recommended punch skin biopsy, which revealed spongiotic dermatitis with subcorneal pustules along with superficial perivascular and mixed lymphocytic and neutrophilic infiltrate with dermal edema and rare eosinophils. Given these findings in conjunction with the patient's fever, elevated liver function, and cervical lymphadenopathy, the rash was consistent with DRESS syndrome or a pustular drug eruption likely secondary to phenytoin or levetiracetam. This case was eventually resolved with treatment with oral and topical corticosteroids and close outpatient follow-up with Dermatology. Prompt diagnosis and treatment of DRESS syndrome are therefore critical as the mortality rate can be as high as 10% in the setting of liver failure.

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Updates and Insights in the Diagnosis and Management of DRESS Syndrome

Cited by 39 publications

References 89 publications

A definite case of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) induced by administration of the Pfizer/BioNTech BNT162b2 vaccine for SARS-CoV2

A definite case of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) induced by administration of the Pfizer/BioNTech BNT162b2 vaccine for SARS-CoV2

Severe Acute Interstitial Nephritis, Dermatitis, and Hemolytic Anemia due to Polyparasitic Infection in an Immunocompetent Male Patient

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

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