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Síndrome DRESS inducido por minociclina con desarrollo de nefritis intersticial aguda DRESS syndrome induced by minocycline with development of acute interstitial nephritis
Veline Martínez
Acta Medica Colombiana , 2012,
Abstract: El síndrome DRESS (reacción a medicamentos con eosinofilia y síntomas sistémicos) es una rara y severa reacción de hipersensibilidad, caracterizado por anormalidades hematológicas y compromiso multiorgánico. Se reporta el caso de una mujer de 35 a os con síndrome DRESS inducido por minociclina, la paciente desarrolló falla renal, nefritis intersticial severa, requiriendo manejo de soporte con hemodiálisis. La función renal se normalizó después de ocho semanas de tratamiento con corticoesteroides. (Acta Med Colomb 2012; 37: 89-92) DRESS syndrome (drug reaction with eosinophilia and systemic symptoms) is a rare and severe hypersensitivity reaction characterized by multiorgan involvement and hematological abnormalities. We present the case of a 35 year old woman with minocycline-induced DRESS syndrome. The patient developed severe interstitial nephritis with renal failure, requiring hemodialysis support management. Renal function returned to normal after eight weeks of treatment with corticosteroids. (Acta Med Colomb 2012; 37: 89-92)
Successful Treatment of Antiepileptic Drug-Induced DRESS Syndrome with Pulse Methylprednisolone  [PDF]
Celebi Kocaoglu,Ceyda Cilasun,Ece Selma Solak,Gulcan S. Kurtipek,Sukru Arslan
Case Reports in Pediatrics , 2013, DOI: 10.1155/2013/928910
Abstract: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but potentially life-threatening syndrome characterized by skin rash, fever, lymph node enlargement, and involvement of internal organs. It is most commonly induced by aromatic anticonvulsants and antibiotics. Nonaromatic anticonvulsants are rarely encountered as the causes of DRESS syndrome. In the present report, three discrete cases with DRESS syndrome developing due to three antiepileptic drugs, including valproic acid (nonaromatic), carbamazepine (aromatic), and lamotrigine (aromatic), and their treatment modalities were aimed to be discussed in light of the literature. To the best of our knowledge, our cases are the first children to be treated with pulse methylprednisolone in the literature. 1. Introduction DRESS syndrome reflects a serious hypersensitivity reaction, especially to antiepileptic drugs. Clinical features include cutaneous eruption, fever, multiple peripheral lymphadenopathies, and potentially life-threatening damage of one or more organs, such as hepatitis, nephritis, or myocarditis. Skin rash, suggestive of DRESS syndrome, includes maculopapular rash or generalized erythematous rash, usually associated with facial edema [1, 2]. Reversion of systemic manifestations is very slow, ranging between 1 and 6 months [3]. Liver is the most frequently affected internal organ [1, 4, 5]. Other systemic involvements like interstitial nephritis, encephalitis, aseptic meningitis, myocarditis, interstitial pneumonitis, or vasculitis may also be seen. Pathogenesis of DRESS remains unclear. Different mechanisms, like detoxification defects causing reactive metabolite formation and subsequent immunological reactions, slow acetylation, and reactivation of human herpesviruses, were implicated in its development [2]. DRESS syndrome is most commonly induced by aromatic anticonvulsants and antibiotics. Nonaromatic anticonvulsants are rarely encountered as the causes of DRESS syndrome [2, 3, 6, 7]. In this report, three discrete cases with DRESS syndrome developing due to three antiepileptic drugs, including valproic acid ((VPA), nonaromatic), carbamazepine (CBZ, aromatic), and lamotrigine ((LMT), aromatic), and their treatment modalities were aimed to be discussed in light of the literature. To the best of our knowledge, our cases are the first children to be treated with pulse methylprednisolone in the literature. 2. Case Presentations 2.1. Case 1 A 12-year-old boy was admitted to the emergency department with the complaints of high grade fever, weakness, and generalised
Levetiracetam-Associated Acute Kidney Injury and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome  [PDF]
Mathieu Leblanc, Martin Plaisance
Open Journal of Nephrology (OJNeph) , 2014, DOI: 10.4236/ojneph.2014.44022
Abstract:
DRESS syndrome is a severe drug induced reaction. Acute kidney injury (AKI) is sometimes present in the form of an acute interstitial nephritis. We present the case of a 75-year-old man with glioblastoma who developed a DRESS two months after starting levetiracetam and a few days after stopping dexamethasone. His skin and kidneys improved after removing levetiracetam and introducing again corticosteroids. DRESS has been reported more frequently with other antiepileptics, rarely with levetiracetam. Clinicians should add this drug to the list of potential causes of AKI.
Sulfasalazine-induced DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms)
Aquino, Renata Telles Rudge de;Vergueiro, Carmen Silvia Vieitas;Magliari, Maria Elisa Ruffolo;Freitas, Thais Helena Proen?a de;
Sao Paulo Medical Journal , 2008, DOI: 10.1590/S1516-31802008000400006
Abstract: context: dress syndrome (drug rash with eosinophilia and systemic symptoms) is a type of drug reaction commonly mistaken for a viral infection. it must be recognized promptly due to its high morbidity and 10% mortality rate. few cases of dress syndrome induced by sulfasalazine have been reported in the literature. case report: the case of a 47-year-old white brazilian woman who developed dress syndrome eight weeks after starting a course of sulfasalazine for treatment of seronegative arthritis is reported. she presented a skin rash, fever, hepatitis, lymphadenopathy, eosinophilia and atypical lymphocytes. the causative drug was discontinued immediately, but she only improved after treatment with prednisone.
Phenobarbitone induced drug reaction with eosinophilia and systemic symptoms (DRESS): a case report  [cached]
Navreet K. Natt,Tarsem Singh,Harmanjit Singh,Manu Sharma
International Journal of Basic & Clinical Pharmacology , 2013, DOI: 10.5455/2319-2003.ijbcp20130620
Abstract: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a life threatening cutaneous drug reaction with visceral involvement and hematological abnormalities. Being a rare side effect, it is often under-reported and misdiagnosed. The fatal adverse drug reaction is associated most commonly with aromatic anti-epileptics phenytoin, carbamazepine and less frequently with phenobarbitone. Here, we report a case of phenobarbitone induced DRESS in a 1 year old male child. He succumbed to fulminant hepatic failure inspite of being put on steroids, hepatoprotectives, antibiotics and ventilatory support. [Int J Basic Clin Pharmacol 2013; 2(3.000): 333-335]
Drug Reaction with Eosinophilia and Systemic Symptoms: DRESS following Initiation of Oxcarbazepine with Elevated Human Herpesvirus-6 Titer  [PDF]
Seth L. Cornell,Daniel DiBlasi,Navin S. Arora
Case Reports in Dermatological Medicine , 2014, DOI: 10.1155/2014/853281
Abstract: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and potentially fatal severe cutaneous reaction, which has a delayed onset after the initiation of an inciting medication. After recognition and withdrawal of the causative agent, along with aggressive management, a majority of patients will have complete recovery over several months. We present a rare case of DRESS secondary to oxcarbazepine with an elevated human herpesvirus-6 titer. 1. Introduction Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, severe, cutaneous reaction that was prototypically associated with aromatic anticonvulsant medications; however, it is now recognized that it can be caused by a variety of pharmacologic agents. Although no consensus has been reached regarding its pathogenesis, reactivation of human herpesvirus-6 (HHV-6) has been associated with DRESS. Presentation typically occurs within six to eight weeks after initiation of an offending medication and often resolves with prompt discontinuation; however, fatal cases have been reported. Here, we present a rare case of DRESS secondary to oxcarbazepine and associated with elevated HHV-6 titer. 2. Case Report A 29-year-old Asian female presented to the emergency department for a progressively worsening rash over the prior week. The eruption originated as a solitary pruritic plaque on her left arm, which over the next two days spread to her trunk and legs. Her family physician initially prescribed a course of valacyclovir for presumed varicella zoster virus infection. She returned to the same provider three days later and the rash was noted to now involve the interdigital aspects of her hands and feet. Permethrin cream was prescribed due to concern for scabies. The lesions continued to worsen and the patient developed a fever and sore throat eight days after the eruption onset. She was subsequently instructed by her primary care provider to go to the emergency department for further evaluation. In the emergency department, she complained of severe pruritis and painful oral lesions but denied having any painful skin lesions, skin sloughing, or any anogenital lesions. On exam, she was tachycardic to 131?bpm but was afebrile, normotensive, and in no acute distress. Cardiovascular and pulmonary examinations were unremarkable. Cutaneous examination revealed numerous erythematous discrete papules and minimal blanching on the bilaterally distal extremities, face, and neck (Figure 1). There were also discrete papules coalescing into nonblanching, erythematous plaques on her trunk and proximal
Vancomycin Hypersensitivity Diagnosed by Lymphocyte Blast Transformation
Nguyen P. Tran,Jeremy Katcher,Erin Rohman,Mary Francis Hall,Christie F. Michael,Isao Miyairi,D. Betty Lew
Case Reports in Pediatrics , 2011, DOI: 10.1155/2011/562620
Abstract: A 15-year-old male admitted for Pott's puffy tumor developed recurrent episodes of fever, diffuse morbilliform rash, eosinophilia, and tubulointerstitial nephritis while on multiple antibiotics. Lymphocyte blast transformation (LBT), a method of detecting cellular immune response by measuring levels of interferon-γ (IFN-γ), was used to diagnose vancomycin hypersensitivity and guide antibiotic selection.
Nefritis intersticial aguda y lamotrigina: Report of one case Acute interstitial nephritis associated to lamotrigine use  [cached]
Gustavo M?nckeberg F,Antonio Vukusich C,Gonzalo Valls G,Helmar Rosenberg G
Revista médica de Chile , 2004,
Abstract: Acute interstitial nephritis is a mononuclear and sterile inflammation of the renal interstice caused by drugs, infections or immune phenomena. The clinical presentation is characterized by the triad of rash, fever and eosinophilia. We report a 32 years old man, in treatment with lamotrigine for depression, admitted to the hospital due to fever, abdominal pain, jaundice, cutaneus rash and malaise. Due to an oliguric renal failure of acute onset, a renal biopsy was done. The pathological study showed a granulomatous acute interstitial nephritis. He was started on hemodialysis and treated with cessation of the drug and corticosteroids, with complete recovery of the renal function (Rev Méd Chile 2004; 132: 742-6)
Uncommon vancomycin: induced side effects
Rocha, Jaime Luís Lopes;Kondo, William;Baptista, Maria Inêz Domingues Kuchiki;Cunha, Clovis Arns da;Martins, Luzilma Terezinha Flenik;
Brazilian Journal of Infectious Diseases , 2002, DOI: 10.1590/S1413-86702002000400007
Abstract: vancomycin has been used with increased frequency during the past 15 years and the most common toxicity with this drug is the "red man syndrome". other adverse effects include neutropenia, fever, phlebitis, nephrotoxicity, ototoxicity, thrombocytopenia, interstitial nephritis, lacrimation, linear iga bullous dermatosis, necrotizing cutaneous vasculitis and toxic epidermal necrolysis. only two cases of vancomycin-induced stevens-johnson syndrome and one case of pancytopenia have been reported in the medical literature. the treatment for both situations is based on cessation of the vancomycin therapy; in cases of stevens-johnson syndrome, antihistamine and/or steroid agents can be used. this article reports a case of pancytopenia and a case of erythema major associated with neutropenia.
Uncommon vancomycin: induced side effects  [cached]
Rocha Jaime Luís Lopes,Kondo William,Baptista Maria Inêz Domingues Kuchiki,Cunha Clovis Arns da
Brazilian Journal of Infectious Diseases , 2002,
Abstract: Vancomycin has been used with increased frequency during the past 15 years and the most common toxicity with this drug is the "red man syndrome". Other adverse effects include neutropenia, fever, phlebitis, nephrotoxicity, ototoxicity, thrombocytopenia, interstitial nephritis, lacrimation, linear IgA bullous dermatosis, necrotizing cutaneous vasculitis and toxic epidermal necrolysis. Only two cases of vancomycin-induced Stevens-Johnson syndrome and one case of pancytopenia have been reported in the medical literature. The treatment for both situations is based on cessation of the vancomycin therapy; in cases of Stevens-Johnson syndrome, antihistamine and/or steroid agents can be used. This article reports a case of pancytopenia and a case of erythema major associated with neutropenia.
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