Anticonvulsant hypersensitivity syndrome: clinic case and literature review

Introduction: The anticonvulsant hypersensitivity syndrome is a rare adverse reaction in which the skin, lymph nodes and internal organs are affected. It is usually caused by classic anticonvulsants such as phenytoin, carbamazepine or phenobarbital. Case report: Here we present the case of a 25-year-old woman from Córdoba, Argentina, who suffered a severe reaction to oxcarbazepine with a rash, lymphadenopathy, hepatitis and an unusual analytic. Clinical abnormalities were reversed after oxcarbazepine was terminated and treatment with diphenhydramine and dexamethasone was initiated. Discussion: DRESS syndrome is a hypersensitivity reaction that takes weeks to manifest, and is characterized by rash, leukocytosis with eosinophilia, adenopathies, liver involvement, and reactivation of the herpes virus 6, being more frequent in carbamazepine or phenytoin, and in rare cases to oxcarbazepine. Conclusions: In general, this strong medicine is not taken into account as a cause of hypersensitivity, reports suggest that it could be related to cases similar to this one, and studies that are more targeted are required, due to the morbidity and mortality of the syndrome.

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Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome)

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.62.03.227 ◽

2016 ◽

Vol 62 (3) ◽

pp. 227-230 ◽

Cited By ~ 4

Author(s):

Soraia Aparecida da Silva ◽

Mariana Maciel Pereira de Figueiredo ◽

Lauro Carneiro Neto ◽

Débora Borowiak Reiss ◽

Mariana Amaranto de Souza Damásio

Keyword(s):

Drug Reaction ◽

Case Report ◽

Literature Review ◽

Hypersensitivity Reaction ◽

Laboratory Tests ◽

Immune Status ◽

Target Organ ◽

Dress Syndrome ◽

Risk Of Mortality ◽

Systemic Symptoms

SUMMARY Objective: To review the hypersensitivity reaction to drugs known as drug reaction with eosinophilia and systemic symptoms (DRESS syndrome), based on a case report. We also intend to discuss the difficulty and importance of disease recognition, since none of the changes is pathognomonic of this disease and failure to identify it may have disastrous consequences for the patient. Method: To describe this case report, in addition to the information collected for clinical assessment, a literature review was performed in the PubMed and Bireme databases in order to retrieve the latest information published in literature on DRESS syndrome. Results: The case of a 20-year old patient is reported. After anamnesis, physical examination and laboratory tests a diagnosis of DRESS syndrome was performed, characterized by rash, hematologic alterations, lymphadenopathy and lesions in target organ. This is a rare syndrome, whose frequency varies according to the drug used and the immune status of the patient, being more often associated with the use of anticonvulsants. Conclusion: The approach and discussion of the topic are of paramount importance, in view of the potential lethality of this treatable syndrome. Recognizing the occurrence of DRESS syndrome and starting treatment as soon as possible is crucial to reduce the risk of mortality and improve prognosis.

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Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): A case with adverse reaction to three drugs alternately administered

Journal of Advanced Pediatrics and Child Health ◽

10.29328/journal.japch.1001022 ◽

2021 ◽

Vol 4 (1) ◽

pp. 001-005

Author(s):

Manieri Sergio ◽

Mirauda Maria P ◽

De Gregorio Fabiola ◽

Colangelo Carmela ◽

Tagliente Maria ◽

...

Keyword(s):

Adverse Reaction ◽

Drug Reaction ◽

Case Report ◽

Mortality Rate ◽

Hypersensitivity Reaction ◽

Genetic Predisposition ◽

Intravenous Immunoglobulins ◽

Dress Syndrome ◽

Pediatric Case ◽

Systemic Symptoms

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe multiorgan hypersensitivity reaction mostly caused by several eliciting drugs in patients with a genetic predisposition. Incidence of DRESS in children is very variable, frome 1:1000 to 1:10.000, and the mortality rate seems to be lower than 10%. Anti-convulsants are the main drugs involved both in adults and in children. The treatment of choice is the prompt withdrawn of the offending drug and using intravenous immunoglobulins and corticosteroids used in synergy. In recent years, emerging studies have outlined the disease more clearly. We present a pediatric case in which the patient developed DRESS syndrome as a result of exposure to lamotrigine before and carbamazepine after and a relapse after exposure to omeprazole. Starting from this case report we provide an overview on DRESS Syndrome.

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DRESS syndrome due to clobazam: a case report

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20205132 ◽

2020 ◽

Vol 9 (12) ◽

pp. 1906

Author(s):

M. Faraz Qureshi ◽

A. N. Dattatari

Keyword(s):

Case Report ◽

Hypersensitivity Reaction ◽

Seizure Disorder ◽

Dress Syndrome ◽

Internal Organs ◽

Idiosyncratic Reaction ◽

Life Threatening ◽

History Of ◽

Drug Rash ◽

Systemic Symptoms

Drug rash (or reaction) with eosinophilia and systemic symptoms (DRESS) is a potentially life-threatening hypersensitivity reaction to drugs characterized by rash, fever, lymphadenopathy, hematologic abnormalities, and involvement of internal organs. Initially coined in 1996, the term is used to refer to an idiosyncratic reaction to several drugs, the most common of which are carbamazepine, allopurinol, sulfasalazine, and phenobarbital. We report the case of DRESS related to clobazam in a 38-year-old female with a history of a complex seizure disorder.

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