[DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) syndrome after sulfasalazine and carmazepine: report of two cases]

Rev Med Interne. 2001 Jun;22(6):582-6. doi: 10.1016/s0248-8663(01)00391-5.
[Article in French]

Abstract

Introduction: To better individualize drug hypersensitivity reaction, Bocquet et al. have recently called this adverse drug reaction DRESS (Drug Rash with Eosinophilia and Systemic Symptoms).

Exegesis: We report two cases of DRESS and highlight the main characteristics of this syndrome. Two patients presented severe febrile skin eruption following drug intake (carbamazepine or sulfazalazine), with hypereosinophilia and hepatitis. All symptoms resolved after drug withdrawal and corticosteroid therapy. DRESS syndrome is an idiosyncratic reaction characterised by febrile eruption, occurring 2 to 6 weeks after the beginning of the treatment, accompanied by systemic symptoms and biological abnormalities (hypereosinophilia, hepatitis). Some complications can occur. This syndrome can be fatal. Numerous drugs can be responsible for this reaction to medication. The physiopathology has not yet been elucidated, and the treatment is not codified, but the triggering agent must immediately be stopped. Corticotherapy is sometimes used.

Conclusion: It is important to recognize this entity recently named DRESS syndrome because it can mimic other pathologies, is potentially serious, and because withdrawal of the incriminating drug is imperative.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Anticonvulsants / adverse effects*
  • Carbamazepine / adverse effects*
  • Chemical and Drug Induced Liver Injury
  • Diagnosis, Differential
  • Drug Hypersensitivity / pathology*
  • Eosinophilia / chemically induced*
  • Exanthema / chemically induced*
  • Female
  • Humans
  • Male
  • Prognosis
  • Sulfasalazine / adverse effects*
  • Syndrome

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents, Non-Steroidal
  • Anticonvulsants
  • Carbamazepine
  • Sulfasalazine