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2013, Number 3

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Rev Med Inst Mex Seguro Soc 2013; 51 (3)

Dress syndrome. A Clinical Case Report

Muciño-Bermejo J, Díaz de León-Ponce M, Briones-Vega CG, Guerrero-Hernández A, Sandoval-Ayala OI, Sáenz-Coronado AG, Briones-Garduño JC
Full text How to cite this article

Language: Spanish
References: 13
Page: 330-335
PDF size: 127.80 Kb.


Key words:

anticonvulsants, drug hypersensitivity, chemically induced, adverse effects.

ABSTRACT

Background: DRESS syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms) or reaction to drugs with eosinophilia and systemic symptoms is a serious drug reaction associated with the use of aromatic anticonvulsants and allopurinol. At least 44 drugs have been associated with DRESS. The aim was to present the case of a patient with DRESS syndrome associated with phenytoin.
Clinical case: a 20 years old woman, with a history of seizures since childhood, presented generalised tonic-clonic seizures for the last three months. Therefore, she began treatment with 100 mg of phenytoin, administered orally, every 8 hours. Three weeks later, she developed fever up to 42 degrees, papules in the hands extending to trunk and extremities, generalized rubicund, pruritus, pain while urinating, adding hyperoxia, dysphagia and dry cough. Consequently, she went to the emergency room.
Discussion: the diagnosis is clinical and it is set according to the criteria of the scale of RegiSCAR. As the initial manifestations are unspecifi c, the diagnosis and treatment could be delayed. The importance of recognizing this syndrome is an early treatment to get better prognostics. The mortality is up to 10 %.


REFERENCES

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  3. Saltzsein SL, Ackerman LV. Lymphadenopathy induced by anticonvulsant drugs and mimicking clinically pathologically malignant lymphomas. Cancer. 1959;12(1):164-82.

  4. Bocquet H, Bagot M, Roujeau JC. Drug-induced pseudolymphoma and drug hypersensitivity syndrome (Drug Rash with Eosinophilia and Systemic Symptoms: DRESS). Semin Cutan Med Surg. 1996; 15(4):250-57.

  5. Pereira de Silva N, Piquioni P, Kochen S, Saidon P. Risk factors associated with DRESS syndrome produced by aromatic and non-aromatic antipiletic drugs. Eur J Clin Pharmacol. 2011;67(5):463-70.

  6. Descamps V, Valance A, Edlinger C, Fillet AM, Grossin M, Lebrun-Vignes B, et al. Association of human herpesvirus 6 infection with drug reaction with eosinophilia and systemic symptoms. Arch Dermatol. 2001;137(3):301-04.

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  8. Kardaun SH, Sidoroff A, Valeyrie-Allanore L, Halevy S, Davidovici BB, Mockenhaupt M, et al. Variability in the clinical pattern of cutaneous sideeffects of drugs with systemic symptoms: does a DRESS syndrome really exist? Br J Dermatol. 2007;156(3): 609-11.

  9. Davidovici B, Dodiuk-Gad R, Rozenman D, Halevy S; Israeli RegiSCAR Network. Profi le of acute generalized exanthematous pustulosis in Israel during 2002-2005: results of the RegiSCAR Study. Isr Med Assoc J. 2008;10:410-12.

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  11. Wongkitisophon P, Chanprapaph K, Rattanakaemakorn P, Vachiramon V. Six-year retrospective review of drug reaction with eosinophilia and systemic symptoms. Acta Derm Venereol. 2012;92(2):200-05.

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  13. Bourgeois GP, Cafardi JA, Groysman V, Pamboukian SV, Kirklin JK, Andea AA, et al. Fulminant myocarditis as a late sequela of DRESS: two cases. J Am Acad Dermatol. 2011;65(4):889-90. Texto libre en http://www.ncbi.nlm.nih.gov/pmc/articles/ PMC3511821/




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Rev Med Inst Mex Seguro Soc. 2013;51