Drug Reaction, Eosinophilia and Systemic Symptoms (DRESS) syndrome secondary to allopurinol with early lymphadenopathy and symptom relapse

Abstract

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare condition with a mortality rate of up to 10%. Herein, we describe a case of DRESS syndrome secondary to allopurinol and which may have been precipitated by amoxicillin, the diagnostic challenge it represented and the successful treatment of the condition with corticosteroids.

Cost effectiveness analysis of HLA-B*58:01 genotyping prior to initiation of allopurinol for gout

“…All-cause mortality was taken from UK life tables [32], adjusted by age and gender, whilst 3month mortality for SJS/TEN and for DRESS were modelled at 26.5% (95% CI 18%, 24%) [6] and 10% (95% CI 5%, 15%) [7], respectively.…”

“…SCARs are associated with high mortality -up to 30% in the case of TEN [6]. Allopurinol is also associated with hypersensitivity adverse drug reactions (ADRs) (hereafter referred to as drug reaction with eosinophilia and systematic symptoms (DRESS)), including drug induced hypersensitivity syndrome (DIHS), also sometimes called allopurinol hypersensitivity syndrome (AHS) or hypersensitivity syndrome (HSS) [7].…”

Successful treatment of drug reaction with eosinophilia and systemic symptoms syndrome relapse with oral pulsed dexamethasone

“…Long-term supraphysiologic doses of corticosteroids are needed to treat DRESS syndrome even after the patient appears to have improved. Relapses are frequent and commonly follow treatment discontinuation or a quick steroid taper as seen in this patient, 3 , 4 which can lead to increased patient morbidity and mortality. Unfortunately, prolonged treatment with high-dose corticosteroids can result in well-known adverse events and is more likely to cause serious complications such as hypothalamic-pituitary-adrenal axis suppression.…”

Drug Rash With Eosinophilia and Systemic Symptoms (DRESS) Syndrome Probably Related to Cefpodoxime: A Case Report

“…Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a severe, idiosyncratic delayed hypersensitivity skin reaction to a drug associated with a range of clinical signs such as fever, diffuse maculopapular rash, hematological abnormalities (eosinophilia or atypical lymphocytes), and multiple internal organ involvement. 1 DRESS syndrome is estimated to have an incidence which ranges from 1 in 1000 to 1 in 10 000 after culprit drug exposure. 1 Anticonvulsants, allopurinol, and sulfonamides are the most commonly associated medications involved in the development of DRESS syndrome, which may also be rarely observed with β-lactam antibiotics.…”

“…1 DRESS syndrome is estimated to have an incidence which ranges from 1 in 1000 to 1 in 10 000 after culprit drug exposure. 1 Anticonvulsants, allopurinol, and sulfonamides are the most commonly associated medications involved in the development of DRESS syndrome, which may also be rarely observed with β-lactam antibiotics. 2 The prolonged latency period of 2 to 6 weeks between medication administration and appearance of the symptoms is a characteristic feature of DRESS syndrome, which may confound the clinical diagnosis.…”