A potentially fatal cause of rash
© Springer-Verlag London Ltd 2010
Received: 17 January 2010
Accepted: 19 April 2010
Published: 20 August 2010
DRESS (drug reaction with eosinophilia and systemic symptoms) is a drug-induced life-threating hypersensivity syndrome that presents with skin rash, fever, eosinophilia and multiple organ involvement (especially kidney and liver injury). Normally clinical signs present within 8 weeks after starting medication. Drugs most frequently implicated are aromatic antiepileptic agents, sulfonamides and allopurinol. Differential diagnosis includes viral, bacterial and parasitologic infections, hypereosinophilic syndrome, neoplastic and autoimmune diseases.
One in 260 patients treated with allopurinol develops DRESS . Renal failure is common, and maculopapular exanthema is the most frequent skin manifestation . The mortality rate is higher in comparison to hypersensivity reactions due to other drugs, reaching approximately 25% in some studies .
When our patient met the DRESS syndrome criteria , allopurinol was stopped, and fluids and steroids were administered. The patient responded to treatment and was discharged in good condition with normal renal function and partial resolution of her skin rash.
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