Adult respiratory distress syndrome (ARDS) due to omeprazole-induced drug reaction with eosinophilia and systemic symptoms (DRESS): Case report and review of the literature

D. Díaz Díaz , C. Olmos Mata , E. Palencia Herrejón , L. López Pérez
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Abstract

Eosinophilia in not an uncommon findings in the intensive care unit (ICU); however, DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) syndrome, which is characterized by a hypersensitivity reaction to drugs and manifests as eosinophilia, systemic involvement and maculopapular erythematous rash 2–6 weeks after exposure to the offending drug, is an exceptional occurrence. We present the first case described in the literature of DRESS syndrome with pulmonary involvement in the form of interstitial pneumonitis and persistent adult respiratory distress syndrome (ARDS) secondary to proton pump inhibitors (PPI). The patient made a good recovery after withdrawal of the offending drug and long-term treatment with systemic corticosteroids.
We also present a systematic review of all cases of DRESS with pulmonary involvement in the form of interstitial pneumonitis and cases of PPI-induced DRESS published to date; none of these describe pulmonary involvement.
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奥美拉唑诱发的伴有嗜酸性粒细胞增多和全身症状的药物反应(DRESS)导致成人呼吸窘迫综合征(ARDS):病例报告和文献综述。
嗜酸性粒细胞增多症在重症监护病房(ICU)中并不少见;然而,DRESS(嗜酸性粒细胞增多和全身症状的药物反应)综合征的特点是对药物的超敏反应,表现为在接触违禁药物 2-6 周后出现嗜酸性粒细胞增多、全身受累和斑丘疹性红斑。我们介绍了文献中描述的第一例因服用质子泵抑制剂(PPI)而继发肺部受累,表现为间质性肺炎和持续性成人呼吸窘迫综合征(ARDS)的 DRESS 综合征。患者在停用违禁药物并长期接受全身皮质类固醇治疗后恢复良好。我们还对迄今为止发表的所有以间质性肺炎形式累及肺部的DRESS病例和PPI诱发的DRESS病例进行了系统回顾;这些病例均未描述肺部受累的情况。
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