Drug reaction with eosinophilia and systemic symptoms (DRESS) induced by allopurinol: A case report

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY European Geriatric Medicine Pub Date : 2013-04-01 DOI:10.1016/j.eurger.2012.11.009

I.A. Engell, G. Authried

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引用次数: 2

Abstract

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe drug-induced reaction. It is characterized by fever, skin eruption, lymphadenopathy, haematological abnormalities and involvement of internal organs. We describe the case of a 74-year-old woman, who developed DRESS, due to intake of allopurinol. She was admitted to the hospital 6 weeks after she had begun taking allopurinol with fever, maculopapular erythema, lymphadenopathy and general malaise. Blood tests revealed eosinophilia, lymphocytosis, severe inflammation and involvement of liver and kidney. PET-CT showed increased FDG uptake in several lymphnotes. She was diagnosed with DRESS, the culprit drug was withdrawn and she was given oral prednisolone. Symptoms resolved within a month. DRESS is a serious condition with mortality up to 10%. It is associated with diagnostic difficulties, as the clinical symptoms are variable and may mimic other conditions. Our case focuses on the recognition and treatment of DRESS.

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别嘌呤醇致嗜酸性粒细胞增多及全身症状(DRESS)的药物反应1例

伴有嗜酸性粒细胞增多和全身症状的药物反应(DRESS)是一种严重的药物诱导反应。它的特点是发热、皮肤出疹、淋巴结病变、血液系统异常和内脏受累。我们描述的情况下，74岁的妇女，谁发展的DRESS，由于摄入别嘌呤醇。患者在开始服用别嘌呤醇6周后因发热、黄斑丘疹红斑、淋巴结病和全身不适入院。血液检查显示嗜酸性粒细胞增多、淋巴细胞增多、严重炎症和累及肝脏和肾脏。PET-CT显示几个淋巴结中FDG摄取增加。她被诊断为DRESS，停用了罪魁祸首药物，并给予口服强的松龙。症状在一个月内消失。DRESS是一种严重的疾病，死亡率高达10%。它与诊断困难有关，因为临床症状是可变的，可能模仿其他情况。本案例的重点是对DRESS的认识和治疗。

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来源期刊

European Geriatric Medicine GERIATRICS & GERONTOLOGY-

CiteScore

6.70

自引率

2.60%

发文量

114

审稿时长

6-12 weeks

期刊介绍： European Geriatric Medicine is the official journal of the European Geriatric Medicine Society (EUGMS). Launched in 2010, this journal aims to publish the highest quality material, both scientific and clinical, on all aspects of Geriatric Medicine. The EUGMS is interested in the promotion of Geriatric Medicine in any setting (acute or subacute care, rehabilitation, nursing homes, primary care, fall clinics, ambulatory assessment, dementia clinics..), and also in functionality in old age, comprehensive geriatric assessment, geriatric syndromes, geriatric education, old age psychiatry, models of geriatric care in health services, and quality assurance.