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

Bayan, Claire-Audrey Y.; López, Ana M.; Fontecilla, Natalia M.; Geskin, Larisa J.

doi:10.1016/j.jdcr.2018.07.015

Cited by 7 publications

(10 citation statements)

References 9 publications

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“…Drug reaction with eosinophilia and systemic syndrome is a nomenclature that evolved after several terms used to describe the characteristic delayed hypersensitivity reaction that occurs with some medications. 1 These reactions are usually preceded by a 2-8 weeks latency from when the offending medications are commenced. 1,2 The index patient developed his symptoms approximately one month after he commenced Dapsone which was erroneously prescribed for an assumed seizure disorder (as neurological reviews showed no evidence of seizure).…”

Section: Discussionmentioning

confidence: 99%

“…1 These reactions are usually preceded by a 2-8 weeks latency from when the offending medications are commenced. 1,2 The index patient developed his symptoms approximately one month after he commenced Dapsone which was erroneously prescribed for an assumed seizure disorder (as neurological reviews showed no evidence of seizure). About a month later, he developed a high-grade fever followed by pleuritic chest pain, breathlessness, abdominal pain, and widespread cutaneous manifestations.…”

Section: Discussionmentioning

confidence: 99%

“…These findings have been reported with DRESS. 1,2,4,5 Cutaneous presentations are multiple, ranging from pruritic eruptions to diffuse maculopapular inflammatory reactions. 5,9 Though several haematological disorders have been identified in DRESS; Eosinophilia is the most frequently occurring in >50% of the cases.…”

Section: Discussionmentioning

confidence: 99%

“…Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a severe idiosyncratic drug reaction characterized by generalized skin eruption, eosinophilia, lymphadenopathy, and end-organ damage. 1 The terminology DRESS is an evolution of several nomenclatures coined to describe an array of presentations that characteristically follow the intake of some medications. 2 It is a complex syndrome requiring a high index of suspicion to diagnose successfully.…”

Section: Introductionmentioning

confidence: 99%

“…The syndrome causes a diverse array of clinical symptoms, anywhere from 2 to 8 weeks after initiating the offending drug. 1,2,4 Mortality associated with DRESS is about 10%, and this is significantly influenced by delayed diagnosis and hence continuous exposure to the offending agent. 2 Several medications have been implicated in the aetiology of DRESS.…”

Section: Introductionmentioning

confidence: 99%

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Dapsone-induced drug reaction with eosinophilia and systemic symptoms (DRESS): the role of the primary care physician

Akor

Ukuonu

Akor

et al. 2021

gmj

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Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare but severe adverse drug reaction with debilitating morbidity and high mortality. The interest of this presentation is to report a case of dress and the role of the healthcare coordinator (family physician) in early diagnosis, prompt treatment and coordination of care. We report a case of a 32-year-old male who was wrongly commenced on Dapsone for seizure disorder from a primary health centre. He presented two months later with a month history of severe dry cough, pleurisy, intermittent breathlessness and high-grade fever. He had a generalized pruritic rash with erythema and desquamation. There was marked oedema of the face and feet with generalized lymphadenopathy. He was jaundiced with tender hepatomegaly. He had dark coloured urine and a trace of proteinuria but normal renal function. There was marked leukocytosis (35*109/l) with eosinophilia (36%). His chest X-ray and viral screen for HBV, HCV and HIV were all negative. The multiple systemic presentations warranted a multidisciplinary review, and a final diagnosis of DRESS was made. His symptoms began to resolve within two days of withdrawal of the offending drug and commencement of oral corticosteroid with supportive care for his symptoms. At six weeks, there was a complete resolution of clinical features, and his laboratory parameters had returned to the baseline. Diagnosis of DRESS can be challenging, and a high index of suspicion is required. The multidisciplinary coordination of care by the first line physicians can also not be overemphasized for good outcomes.

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Section: Discussionmentioning

confidence: 99%