scholarly journals Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Associated with Mycoplasma pneumoniae Infection

2020 ◽  
Vol 12 (3) ◽  
pp. 225-230
Author(s):  
Guy Shalom ◽  
Raed Khoury ◽  
Amir Horev
Keyword(s):  
Drug Reaction ◽  
Mycoplasma Pneumoniae ◽  
Drug Allergy ◽  
Drug Eruption ◽  
Interferon Γ ◽  
Mycoplasma Infection ◽  
Release Test ◽  
Tnf Α ◽  
Systemic Symptoms

Mycoplasma infection may lower the threshold for drug allergy in particular patients. We present a case of drug reaction with eosinophilia and systemic symptoms (DRESS), with drug etiology and non-drug etiology (Mycoplasma infection). Possible synergism between previously known drug allergy and the acute Mycoplasma infection may have led to DRESS eruption. Interferon-γ release test and TNF-α release test yielded different patterns in the present case, suggesting a different role for each in different drug eruption types.

scholarly journals 812. Case–Control Trial to Evaluate the Cytokine Response to the Use of Capsule Thalidomide in Erythema Nodosum Leprosum in Leprosy Patients

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S290-S291
Author(s):  
Ajay Chopra ◽  
Debdeep Mitra ◽  
Barnali Mitra
Keyword(s):  
Immune Response ◽  
Erythema Nodosum ◽  
Skin Lesions ◽  
Interferon Γ ◽  
Controlled Study ◽  
Type Ii ◽  
Drug Of Choice ◽  
Erythema Nodosum Leprosum ◽  
Tnf Α ◽  
Systemic Symptoms

Abstract Background Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae. Type II lepra reaction or Erythema Nodosum Leposum is a Type III hypersentivity immune response during the chronic course of the illness. This immune response presents as systemic symptoms and neutrophilic leukocytosis, similar to sepsis. Capsule Thalidomide is considered the drug of choice, when it comes to the treatment of this acute immunological emergency. A rational study into the immunological markers involved in the pathogenesis of erythema nododsum leprosum and its successful suppression by Thalidomide should be helpful in early diagnosis and prompt successful therapy. On the basis of previous studies, our aim was to find a correlation with interferon-γ, tumour necrosis factor-α, and Cd-64 expression on activated circulating neutrophils during Type II lepra reaction and successful response to capsule Thalidomide. Methods This case-controlled study included one group of patients diagnosed to have leprosy and the other group was healthy controlled individuals with matched age, sex, and area of residence. All the patients with type II lepra reaction responded to Capsule Thalidomide clinically, and all the skin lesions resolved in 7–14 days. Blood samples and skin biopsy were subjected to histopathology, immunoflourescence assay, immunohistochemical staining, quantitative RT-PCR (reverse transcriptase-polymerase chain reaction), and flow cytometry. Results Interferon-γ and TNF-α are sensitive markers in diagnosing erythema nodosum leprosum and Cd-64 expression on activated circulating neutrophils is both a specific and sensitive marker in Type II lepra reaction. Cd-64 expression also had a positive correlation with Thalidomide treatment and clinical response. High polymorphonuclear Cd-64 expression was correlated with severity of ENL. Conclusion Cd-64 expression on circulating neutrophils is a potential early biophysical marker for diagnosing erythema nodosum leprosum and can be used as a tool to assess thalidomide response. It is however not a good index to diagnose leprosy infection as it was specific for Type II lepra reaction. Interferon-γ and TNF-α are sensitive markers to screen for lepra reactions and this study showed no significant correlation with Thalidomide therapy. Disclosures All authors: No reported disclosures.

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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