Drug Rash with Eosinophilia and Systemic Symptoms Syndrome in a Patient on Sulfasalazine for Ulcerative Colitis

Abstract

DRESS has been reported to be as high as 10%; therefore, prompt diagnosis is essential to improve the prognosis. 3 Sulfasalazine is one of the essential drugs used for the treatment of IBD as well as rheumatic diseases such as rheumatoid arthritis and spondyloarthropathies. 4 While many studies have described experiences of sulfasalazine-induced DRESS in rheumatic diseases, 5,6 few such reports have examined in relation to IBD. 7,8 We herein describe a case of DRESS on sulfasalazine treatment of UC for 6 weeks and present a short review of the literature. CASE REPORTA 22-year-old man presented with a sudden onset of symptoms consistent with viral infection, including fever, chills, myalgia, and generalized skin rash. He had been taking 4.5 g of sulfasalazine for 6 weeks to treat newly diagnosed UC from the referring hospital. Fever and skin rash developed 2 weeks before admission to our hospital. Skin eruptions presented first on the trunk, followed by the rest of the body. The patient denied any history of drug allergy. On admission, body temperature was 38.5 o C, blood pressure was 110/80