Drug Rash With Eosinophilia and Systemic Symptoms Syndrome Induced by Allopurinol

Abstract

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is an adverse drug reaction caused by an apparent group of drugs which can cause 10-20% mortality. It is characterized by a latency period ranging from 3 weeks to 3 months after the introduction of the offending drug. The syndrome is defined by the presence of fever, rash, eosinophilia, atypical lymphocytes and multiorgan involvement. We present a 39-year-old woman who developed fever, nausea, a pruritic erythematous maculopapular rash and facial edema during her sixth week of the treatment with allopurinol as a case of DRESS syndrome. Diagnosis was confirmed by the drug rash, eosinophilia and systemic involvement including adenopathy, toxic hepatitis and pericardial effusion. Allopurinol was discontinued and intravenous prednisolone 60 mg/day was started. The patients clinical appearance and eosinophilia improved within first 2 days. Awareness of hematologic abnormalities and systemic involvement along with drug rush, by physicians is critical for early diagnosis of this life-threatening syndrome.




J Med Cases. 2014;5(7):420-422
doi: https://doi.org/10.14740/jmc1811w