Thyroid dysfunction in drug reaction with eosinophilia and systemic symptoms (DRESS): an unusual manifestation of systemic drug hypersensitivity

2013 ◽  
Vol 168 (5) ◽  
pp. 1130-1132 ◽  
Author(s):  
H. Cookson ◽  
D. Creamer ◽  
S. Walsh
Keyword(s):  
Drug Reaction ◽  
Thyroid Dysfunction ◽  
Drug Hypersensitivity ◽  
Unusual Manifestation ◽  
Systemic Symptoms ◽  
Systemic Drug

scholarly journals DRESS Syndrome in a Teenage Male Associated With Hhv-6 Reactivation While on Prolonged TMP-SMX Use

2021 ◽  
Author(s):  
Dalia Conteras ◽  
Iris Pecson ◽  
Alvaro Galvis
Keyword(s):  
Drug Reaction ◽  
Healthcare Providers ◽  
Delay In Diagnosis ◽  
High Clinical Suspicion ◽  
Johnson Syndrome ◽  
Life Threatening ◽  
Steven Johnson Syndrome ◽  
Systemic Symptoms ◽  
Disseminated Disease ◽  
Systemic Drug

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a rare and potentially life-threatening systemic drug reaction with skin involvement. We present the unusual case of DRESS in a 16-year-old male that was treated with TMP-SMX for acne and was initially misdiagnosed with Steven Johnson Syndrome. Our case serves as an example to healthcare providers treating adverse drug reactions to having a high clinical suspicion for DRESS as delay in diagnosis and treatment can result in disseminated disease and higher patient mortality risk.

scholarly journals Drug-related relapses in drug reaction with eosinophilia and systemic symptoms (DRESS)

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Lukas Jörg ◽  
Arthur Helbling ◽  
Daniel Yerly ◽  
Werner J. Pichler
Keyword(s):  
Drug Reaction ◽  
Drug Testing ◽  
Drug Hypersensitivity ◽  
Lymphocyte Transformation ◽  
Lymphocyte Transformation Test ◽  
New Drugs ◽  
University Hospital ◽  
Skin Tests ◽  
Multiple Drug ◽  
Systemic Symptoms

Abstract Background A drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe T cell mediated hypersensitivity reaction. Relapses of symptoms in the recovery phase are frequent and linked to the reduction of the corticosteroid treatment, to viral reactivations or to the exposure to new drugs. Here, we analyzed, how often the exposure to new drugs leads to new sensitization or drug-related relapses without detectable sensitization. Methods 46 patients with DRESS treated in the allergy division of the Inselspital, Bern University Hospital, were retrospectively assessed. Drug-related relapses were analyzed in terms of frequency and whether a possible sensitization evaluated by skin tests and/or lymphocyte transformation tests (LTT) to the new drugs was detectable. Furthermore, drug tolerance was evaluated in a subset of patients. Results 56 relapses were observed in 27 of 46 patients with DRESS (58.7%). 33 (58.9%) of these relapses were associated with the use of new drugs, 30 drug-related relapses were evaluated by patch test and/or lymphocyte transformation test. In 8/30 (26.7%) drug-related relapses, a sensitization to the new drug was demonstrated, suggesting the emergence of a multiple drug hypersensitivity syndrome (MDH). 14 patients experienced 22 drug-related relapses without any detectable sensitization and only 1/6 patients developed new symptoms upon reexposure. Conclusion Patients with DRESS frequently suffered from drug related relapses. Half of the patients with drug-related relapses developed a MDH with proven sensitizations not only to the DRESS inducing drugs, but also to newly applied drugs. When not sensitized, drugs involved in drug related relapses could be reintroduced, if needed. Here, we propose a procedure for drug testing and future management of drug-related relapses in DRESS.

scholarly journals Viral Infections and Cutaneous Drug-Related Eruptions

2021 ◽  
Vol 11 ◽  
Author(s):  
Eleonora Anci ◽  
Camille Braun ◽  
Annalisa Marinosci ◽  
Frédérique Rodieux ◽  
Elise Midun ◽  
...  
Keyword(s):  
Drug Reaction ◽  
Viral Infections ◽  
Current Knowledge ◽  
Drug Hypersensitivity ◽  
Acute Infection ◽  
Maculopapular Rash ◽  
Skin Lesions ◽  
Drug Induced ◽  
Barr Virus ◽  
Systemic Symptoms

In the general population, up to 10% of children treated by antibiotics have cutaneous adverse drug reaction, but allergy is confirmed in less than 20% of patients. Most of the non-allergic reactions are probably due to virus, such as enterovirus acute infection or Ebstein-Barr Virus (EBV) acute infection or reactivation. Especially in children, viruses have the propensity to induce skin lesions (maculopapular rash, urticaria) due to their skin infiltration or immunologic response. In drug-related skin eruptions, a virus can participate by activating an immune predisposition. The culprit antibiotic is then the trigger for reacting. Even in severe drug-induced reactions, such as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome, viruses take part in immune phenomena, especially herpes viruses. Understanding the mechanisms of both virus- and drug-induced skin reaction is important to develop our clinical reflection and give an adaptive care to the patient. Our aim is to review current knowledge on the different aspects and potential roles of viruses in the different type of drug hypersensitivity reactions (DHR). Although major advances have been made those past year, further studies are needed for a better understanding of the link between viruses and DHR, to improve management of those patients.

When fever is more than infection: two cases of vancomycin-induced drug reaction with eosinophilia and systemic symptoms (DRESS)

2021 ◽  
Vol 14 (1) ◽  
pp. e238006
Author(s):  
Mitchell Cox ◽  
Sophie Paviour ◽  
Sophie Gregory ◽  
Rusheng Chew
Keyword(s):  
Drug Reaction ◽  
Cytomegalovirus Reactivation ◽  
First Case ◽  
Metropolitan Hospital ◽  
Orthopaedic Ward ◽  
Systemic Hypersensitivity ◽  
Systemic Symptoms ◽  
Inflammatory Syndrome ◽  
Intravenous Glucocorticoids

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, but serious systemic hypersensitivity reaction associated with a range of medications. We present two cases of vancomycin-induced DRESS, which occurred simultaneously in the orthopaedic ward in an outer metropolitan hospital. These cases demonstrate the complexity in the diagnosis and management of this inflammatory syndrome on the background of known infection as well as evidence for linezolid as an alternative to vancomycin. The first case was managed conservatively, but developed progressive renal and liver injury along with demonstrated cytomegalovirus reactivation and recurrent colitis, and was eventually palliated. The second was commenced on intravenous glucocorticoids and achieved remission, although had ongoing renal dysfunction at the time of discharge from outpatient follow-up.

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