DRESS and Stevens–Johnson Syndrome Overlap Secondary to Allopurinol in a 50-Year-Old Man—A Diagnostic and Treatment Challenge: Case Report

Abstract

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a drug reaction commonly related to eosinophilia, from uncertain epidemiology, and without consensus for diagnosis and treatment globally. It presents a great challenge in its management and is characterized by fever, lymphadenopathy, skin rash, and multisystemic involvement. An aggressive and difficult-to-manage clinical case is presented in a 50-year-old man with chronic kidney disease due to diabetes mellitus type 2 and systemic arterial hypertension, who developed an unusual variant similar to DRESS and Stevens–Johnson syndrome (SJS) overlap secondary to allopurinol, with skin manifestations without eosinophilia, but fulfilling clinical and laboratory criteria for DRESS and SJS syndrome.

Drug Reaction with Eosinophilia and Systemic Symptoms Induced by Diosmin and Hesperidin: A Case Report

“… 1 , 2 Fulminant liver failure is found to be the most common cause of death. 3 As immediate withdrawal of the offending drug and systemic corticosteroids to control systemic involvement constitutes a mainstream therapy for DRESS, identifying the offending drug is necessary.…”