An Uncommon Presentation of DRESS Syndrome Secondary to Leflunomide Use: A Case Report

Rao, Suman; Sunkara, Akhila; Srivastava, Neetu; Sampat, Parth J; Ramos, Christopher; Albert, Emily

doi:10.1177/2324709621997282

Cited by 8 publications

(10 citation statements)

References 11 publications

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“…It is a systemic, severe drug hypersensitivity syndrome, typically encountered in adults but is uncommon in children. [2,7]. According to the RegiSCAR scoring system, which categorizes DRESS Syndrome as "excluded," "possible," "probable," or "definite" and on this basis the diagnosis of the patient is made 3.…”

Section: Discussionmentioning

confidence: 99%

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A case report on drug rash with Eosinophiilia and systemic symptoms (DRESS) syndrome

Patel¹,

Patel²,

Desai³

et al. 2023

GSC Biol. Pharm. Sci.

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Background: DRESS syndrome is a distinctive, severe, and atypical drug reaction includes drug rash with eosinophilia and organ dysfunction symptoms, as well as hematological abnormalities. This disease is diagnosed using the Regis CAR (European Registry of Severe Cutaneous Adverse Reaction) scoring system. Case presentation: A 25-year-old lady presented with complaints of skin lesion over whole body since 3 days along with multiple clear fluid filled blisters over face and chin and lesions in oral cavity, multiple ill-defined areas of erythema with multiple bullae over face and chin. She also had complained about was also having cough, breathlessness and chest pain. Conclusion: DRESS syndrome is a severe hypersensitivity reaction caused by a reaction from drug, which in this case is found to be allopurinol. The treatment for the same is firstly the withdrawal of causative drug and using corticosteroids,in this patient dexamethasone was used.

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Section: Discussionmentioning

confidence: 99%

“…DRESS syndrome has been linked to antiepileptic drugs such as phenytoin, lamotrigine and carbamazepine. Antibiotics that contain sulfa, minocycline, and vancomycin have also been linked to this syndrome [7]. Kawasaki disease is the second most common cause of vasculitis in children after Henoch Schonlein purpura like DRESS Syndrome [8].…”

Section: Introductionmentioning

confidence: 99%

A case report on drug rash with Eosinophiilia and systemic symptoms (DRESS) syndrome

Patel¹,

Patel²,

Desai³

et al. 2023

GSC Biol. Pharm. Sci.

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“…While gastrointestinal events such as nausea and diarrhea are the most reported adverse effects of LEF therapy [7], DRESS syndrome is rarely reported. A literature review of PubMed revealed only nine previous cases of LEF-induced DRESS syndrome have been reported [8][9][10][11][12], suggesting that the rate of LEF-induced DRESS syndrome is significantly less than the average incidence.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Leflunomide-Induced Drug Reaction With Eosinophilia and Systemic Symptom (DRESS) Syndrome Despite Prolonged Steroid Taper: A Case Report

Gayfield¹,

Busken²,

Mansur³

2022

Cureus

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Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe adverse drug reaction characterized primarily by nonspecific systemic symptoms such as fever, a classical rash, and eosinophilia. While this is an adverse reaction more often related to medications such as anticonvulsants, many drugs have been reported to be implicated in this event. We report a case of a 35-year-old male who developed DRESS syndrome within one month of beginning leflunomide therapy. Despite treatment with a prolonged steroid taper, he developed a flare-up with transaminitis less than two months after his initial hospitalization. Our patient was managed with steroid pulse therapy and cyclosporine, which resulted in an improvement of symptoms and transaminitis. To our knowledge, only nine previous cases of leflunomideinduced DRESS syndrome have been previously reported.

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“…Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, is a rare and potentially life-threatening multiorgan system reaction with a constellation of symptoms such as rash, fever, swelling, lymphadenopathy, leukocytosis and eosinophilia,with the most distinct feature being end organ dysfunction. [1][2][3] The incidence of DRESS syndrome in new users is approximately 1 per 1500 and has a mortality rate of 10%. 4 The most frequent culprit drugs are anticonvulsants (phenytoin, phenobarbital), allopurinol and sulfonamides, with a long prodromal period of 2 to 6 weeks.…”

Section: Introductionmentioning

confidence: 99%

Phenytoin Induced Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome: A Clinical Case Report

Varghese¹,

Alosious²,

Thomas³

et al. 2022

Journal of Pharmacy Practice

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Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially life-threatening hypersensitivity reaction with cutaneous presentation and internal organ involvement. We herein present a case of phenytoin induced DRESS syndrome in a 56- year-old male who presented with high-grade fever and chills, cough with expectoration and generalized maculopapular rash. Laboratory findings revealed eosinophilia, leukocytosis, thrombocytopenia, transaminitis and elevated inflammatory markers. Further clinical, radiological and histopathological assessments confirmed the diagnosis. Phenytoin was discontinued, and patient was started on intravenous dexamethasone, which was later switched to oral prednisone. Rapid resolution of fever, eosinophilia and progressive improvement in skin rash and liver dysfunction was observed. Our report highlights the importance of prompt recognition of DRESS syndrome and the need for a guideline directed therapy for the management of this adverse drug reaction.

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An Uncommon Presentation of DRESS Syndrome Secondary to Leflunomide Use: A Case Report

Cited by 8 publications

References 11 publications

A case report on drug rash with Eosinophiilia and systemic symptoms (DRESS) syndrome

A case report on drug rash with Eosinophiilia and systemic symptoms (DRESS) syndrome

Recurrent Leflunomide-Induced Drug Reaction With Eosinophilia and Systemic Symptom (DRESS) Syndrome Despite Prolonged Steroid Taper: A Case Report

Phenytoin Induced Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome: A Clinical Case Report

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