Acute Hepatitis in the DRESS Syndrome

Acute Hepatitis in the DRESS Syndrome

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, idiosyncratic reaction characterized by diffuse maculopapular rash, facial edema, lymphadenopathy, fever, eosinophilia and/or other leukocyte abnormalities, and involvement of internal organs as liver, kidney, heart and lung. Diagnosing this entity is specifically complicated due to the multiplicity of organs involved. DRESS syndrome must be recognized promptly and the causative drug withdrawn in order to improve patient outcomes. Indeed, it is a potentially life-threatening condition, with a reported mortality between 5 and 20%. We describe a case of a 22-year old woman admitted to our hospital with acute diffuse, pruritic rash associated with crampy abdominal pain, vomiting, diarrhea and fever three weeks after starting sulfasalazine therapy. Initially, laboratory parameters revealed normal white blood cell count and normal liver enzymes, but during hospitalization, eosinophilia developed and liver enzymes, including transaminases and cholestatic parameters, dramatically increased. The diagnostic of DRESS syndrome was made and sulfasalazine was withdrawn and as there were signs of disease severity, systemic corticotherapy was initiated, with gradually improvement of the rash and symptoms resolution. The patient was discharged home after thirty days of hospitalization.

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Autores principales: Oliveira,Ana Maria, Carvalho,Rita, Martins,Alexandra, Reis,Jorge
Formato: Digital revista
Idioma:English
Publicado: Sociedade Portuguesa de Gastrenterologia 2016
Acceso en línea:http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452016000600005
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spelling oai:scielo:S2341-454520160006000052017-08-28Acute Hepatitis in the DRESS SyndromeOliveira,Ana MariaCarvalho,RitaMartins,AlexandraReis,Jorge Drug Hypersensitivity Syndrome Drug-Induced Liver Injury Liver Failure, Acute/chemically induced Sulfasalazine/adverse effects Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, idiosyncratic reaction characterized by diffuse maculopapular rash, facial edema, lymphadenopathy, fever, eosinophilia and/or other leukocyte abnormalities, and involvement of internal organs as liver, kidney, heart and lung. Diagnosing this entity is specifically complicated due to the multiplicity of organs involved. DRESS syndrome must be recognized promptly and the causative drug withdrawn in order to improve patient outcomes. Indeed, it is a potentially life-threatening condition, with a reported mortality between 5 and 20%. We describe a case of a 22-year old woman admitted to our hospital with acute diffuse, pruritic rash associated with crampy abdominal pain, vomiting, diarrhea and fever three weeks after starting sulfasalazine therapy. Initially, laboratory parameters revealed normal white blood cell count and normal liver enzymes, but during hospitalization, eosinophilia developed and liver enzymes, including transaminases and cholestatic parameters, dramatically increased. The diagnostic of DRESS syndrome was made and sulfasalazine was withdrawn and as there were signs of disease severity, systemic corticotherapy was initiated, with gradually improvement of the rash and symptoms resolution. The patient was discharged home after thirty days of hospitalization.info:eu-repo/semantics/openAccessSociedade Portuguesa de GastrenterologiaGE-Portuguese Journal of Gastroenterology v.23 n.6 20162016-12-01info:eu-repo/semantics/reporttext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452016000600005en10.1016/j.jpge.2016.06.001
institution SCIELO
collection OJS
country Portugal
countrycode PT
component Revista
access En linea
databasecode rev-scielo-pt
tag revista
region Europa del Sur
libraryname SciELO
language English
format Digital
author Oliveira,Ana Maria
Carvalho,Rita
Martins,Alexandra
Reis,Jorge
spellingShingle Oliveira,Ana Maria
Carvalho,Rita
Martins,Alexandra
Reis,Jorge
Acute Hepatitis in the DRESS Syndrome
author_facet Oliveira,Ana Maria
Carvalho,Rita
Martins,Alexandra
Reis,Jorge
author_sort Oliveira,Ana Maria
title Acute Hepatitis in the DRESS Syndrome
title_short Acute Hepatitis in the DRESS Syndrome
title_full Acute Hepatitis in the DRESS Syndrome
title_fullStr Acute Hepatitis in the DRESS Syndrome
title_full_unstemmed Acute Hepatitis in the DRESS Syndrome
title_sort acute hepatitis in the dress syndrome
description Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, idiosyncratic reaction characterized by diffuse maculopapular rash, facial edema, lymphadenopathy, fever, eosinophilia and/or other leukocyte abnormalities, and involvement of internal organs as liver, kidney, heart and lung. Diagnosing this entity is specifically complicated due to the multiplicity of organs involved. DRESS syndrome must be recognized promptly and the causative drug withdrawn in order to improve patient outcomes. Indeed, it is a potentially life-threatening condition, with a reported mortality between 5 and 20%. We describe a case of a 22-year old woman admitted to our hospital with acute diffuse, pruritic rash associated with crampy abdominal pain, vomiting, diarrhea and fever three weeks after starting sulfasalazine therapy. Initially, laboratory parameters revealed normal white blood cell count and normal liver enzymes, but during hospitalization, eosinophilia developed and liver enzymes, including transaminases and cholestatic parameters, dramatically increased. The diagnostic of DRESS syndrome was made and sulfasalazine was withdrawn and as there were signs of disease severity, systemic corticotherapy was initiated, with gradually improvement of the rash and symptoms resolution. The patient was discharged home after thirty days of hospitalization.
publisher Sociedade Portuguesa de Gastrenterologia
publishDate 2016
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452016000600005
work_keys_str_mv AT oliveiraanamaria acutehepatitisinthedresssyndrome
AT carvalhorita acutehepatitisinthedresssyndrome
AT martinsalexandra acutehepatitisinthedresssyndrome
AT reisjorge acutehepatitisinthedresssyndrome
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