scholarly journals Clinico-pathological features of the drug reaction with eosinophilia and systemic Symptoms syndrome: A case study

2021 ◽  
pp. 41-43
Author(s):  
Sowmya Nagarajan ◽  
Harsha N S ◽  
Sneha Jagadeesh ◽  
Deepak K S ◽  
Yeshaswini S Pujar
Keyword(s):  
Drug Reaction ◽  
Pathological Features ◽  
Cutaneous Manifestations ◽  
Maculopapular Eruption ◽  
Cutaneous Adverse Reaction ◽  
History Of ◽  
Facial Edema ◽  
Systemic Manifestations ◽  
Systemic Symptoms

Drug reaction with eosinophilia and systemic symptoms syndrome is a syndrome with a varied spectrum of clinical features. The cutaneous manifestations can be an urticarial, maculopapular eruption also including, vesicles, bullae, pustules, purpura, target lesions, facial edema, cheilitis, and erythroderma. Systemic manifestations include lymphadenopathy, fever, and leukocytosis (often with eosinophilia or atypical lymphocytosis), as well as hepatitis, nephritis, pneumonitis, myositis, and gastroenteritis, in descending order. Diagnosis can be made on the basis of the clinical picture and the RegiSCAR (Registry of Severe Cutaneous Adverse Reaction group) scoring system. Here, we present the case of a 40-year-old male with a history of herbal medicine intake after which he developed a diffuse skin rash.

scholarly journals Angioimmunoblastic T-Cell Lymphoma Mimicking Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS Syndrome)

2017 ◽  
Vol 9 (1) ◽  
pp. 74-79 ◽  
Author(s):  
Joanna Mangana ◽  
Emmanuella Guenova ◽  
Katrin Kerl ◽  
Mirjana Urosevic-Maiwald ◽  
Valerie C. Amann ◽  
...  
Keyword(s):  
Drug Reaction ◽  
T Cell ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
High Dose ◽  
Dress Syndrome ◽  
Cutaneous Manifestations ◽  
Angioimmunoblastic T Cell Lymphoma ◽  
Drug Eruptions ◽  
Systemic Symptoms

Angioimmunoblastic T-cell lymphoma (AITCL) is a rare, aggressive lymphoma which derives from follicular helper T cells, commonly affecting the elderly population. It accounts for 2% of all non-Hodgkin lymphomas, with a reported 5-year overall survival rate of less than 30%. Very often, the clinical picture of AITCL encompasses systemic symptoms such as generalized lymphadenopathy, hepatosplenomegaly, skin rash, anemia, and polyclonal hypergammaglobulinemia. Here we report on the case of a female patient who presented with clinical features resembling drug reaction with eosinophilia and systemic symptoms (DRESS syndrome) prior to the definitive diagnosis of AITCL. The index of suspicion for cutaneous manifestations of lymphoma, and especially AITCL, must be high, particularly in atypical clinical courses of drug eruptions or if skin lesions relapse and are refractory to standard high-dose systemic corticosteroids.

DRESS syndrome: an important differential for eosinophilia with systemic organ dysfunction

2020 ◽  
Vol 13 (5) ◽  
pp. e234251 ◽  
Author(s):  
Whoasif Mukit ◽  
Richard Cooper ◽  
Harmesh Moudgil ◽  
Nawaid Ahmad
Keyword(s):  
Adverse Drug Reaction ◽  
Adverse Reaction ◽  
Drug Reaction ◽  
Clinical Response ◽  
Organ Dysfunction ◽  
Patient Harm ◽  
Dress Syndrome ◽  
Cutaneous Adverse Reaction ◽  
Drug Rash ◽  
Systemic Symptoms

Drug rash occurring with eosinophilia and systemic symptoms syndrome is a potentially fatal adverse drug reaction that requires immediate action in order to minimise patient harm. Initially implicated with the use of anticonvulsants, it has also been shown to be caused by many other medications but less frequently with vancomycin. Patients typically present with fever, lymphadenopathy, eosinophilia and systemic organ dysfunction. Diagnosis is aided using probability calculators such as RegiSCAR (Registry of Severe Cutaneous Adverse Reaction), as well as clinical response on removing the responsible medication. Here, we present a case without any systemic organ dysfunction that improved with withdrawal of the offending drug vancomycin.

Reviewing the Mechanistic Evidence Assessors E-Synthesis and EBM+: A Case Study of Amoxicillin and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)

2019 ◽  
Vol 25 (16) ◽  
pp. 1866-1880 ◽  
Author(s):  
Ahmad Y. Abdin ◽  
Daniel Auker-Howlett ◽  
Jürgen Landes ◽  
Glorjen Mulla ◽  
Claus Jacob ◽  
...  
Keyword(s):  
Decision Making ◽  
Drug Reaction ◽  
Basic Science ◽  
Science Research ◽  
Medical Decision ◽  
Causal Connection ◽  
Controlled Environments ◽  
Systemic Symptoms ◽  
Synthesis Approach

Background: Basic science has delivered unprecedented insights into intricate relationships on the smallest scales within well-controlled environments. Addressing pressing societal decision problems requires an understanding of systems on larger scales in real-world situations. Objective: To assess how well the evidence assessors E-Synthesis and EBM+ assess basic science findings to support medical decision making. Method: We demonstrate the workings of E-Synthesis and EBM+ on a case study: the suspected causal connection between the widely-used drug amoxicillin (AMX) and the putative adverse drug reaction: Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). Results: We determine an increase in the probability that AMX can cause DRESS within the E-Synthesis approach and using the EBM+ standards assess the basic science findings as supporting the existence of a mechanism linking AMX and DRESS. Conclusions: While progress is made towards developing methodologies which allow the incorporation of basic science research in the decision making process for pressing societal questions, there is still considerable need for further developments. A continued dialogue between basic science researchers and methodologists, philosophers and statisticians seems to offer the best prospects for developing and evaluating continuously evolving methodologies.

scholarly journals Lamotrigine Induced DRESS Syndrome in a Child: A Case Report and Literature Review

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1063
Author(s):  
Chien-Heng Lin ◽  
Sheng-Shing Lin ◽  
Syuan-Yu Hong ◽  
Chieh-Ho Chen ◽  
I-Ching Chou
Keyword(s):  
Drug Reaction ◽  
Case Report ◽  
Skin Rash ◽  
Stable Condition ◽  
Anticonvulsant Drug ◽  
Dress Syndrome ◽  
Life Threatening ◽  
History Of ◽  
History Of Epilepsy ◽  
Systemic Symptoms

Lamotrigine is an important anticonvulsant drug. Its use, however, has been limited by the risk of potentially life-threatening dermatological reactions, such as a drug reaction with eosinophilia and systemic symptoms (DRESS). Here, we report the case of a 7-year-6-month-old girl with a history of epilepsy who developed a skin rash with dyspnoea after 2 weeks of lamotrigine treatment, with DRESS ultimately being diagnosed. After discontinuation of the offending drug and the initiation of systemic glucocorticosteroids, the DRESS symptoms were relieved and the patient was discharged in a stable condition. Anticonvulsant drugs such as lamotrigine are among the factors that induce DRESS in children. When a patient displays skin rash and systemic organ involvement following the initiation of an anticonvulsant drug, DRESS should not be overlooked as a diagnosis, and immunosuppressant drugs should be considered as an option for treating DRESS patients.

scholarly journals Cutaneous Manifestations of COVID-19: A Case Series from Brazil

2020 ◽  
Vol 78 (4) ◽  
pp. 329-334
Author(s):  
David De Almeida Souza ◽  
Daniela Alves Pereira Antelo
Keyword(s):  
Case Series ◽  
Skin Lesions ◽  
Daily Routine ◽  
Skin Involvement ◽  
Cutaneous Manifestations ◽  
Infected People ◽  
Maculopapular Eruption ◽  
The World ◽  
Systemic Symptoms ◽  
Epidemiological Characteristics

Introduction: Brazil has presented alarming and growing data on infection and deaths from SARS-CoV-2. There are more than 4 500 000 confirmed cases and more than 137 000 deaths ranking second in the world ranking of infected people. In addition to the involvement of the respiratory, cardiovascular, renal and neurological systems, this virus also causes non-specific skin lesions in same patients. Little is known about the pathophysiology of cutaneous involvement. At this moment, we cannot predict a difference in prognosis based on skin lesions. Methods: We conducted an observational case study of 25 patients affected by SARS-CoV-2 who had dermatological lesions. We described the clinical and epidemiological characteristics of each case, demonstrating the polymorphism of the skin lesions and also making a correlation with the chronology of presented systemic symptoms. Results: Twenty five cases of COVID-19 with cutaneous manifestations (urticaria, erythematous rash, maculopapular eruption, pruritus, erythema multiforme-like lesions, dyshidrotic eczema) were observed during, after and before systemic symptoms. A few cases with skin involvement were also observed as isolated symptoms of the viral infection. These data demonstrate the clinical polymorphism related to skin involvement of patients infected with SARS-CoV-2, emphasizing the importance of clinical suspicion by dermatologists when handling suspected cases in the current epidemiological scenario. Conclusion: Although the number of cases in the world stage seems to be regressing, infection by SARS-CoV-2 will be part of the dermatologist's daily routine. As long as we do not have a widely available vaccine and the pandemic takes on an endemic profile, we need to be aware of these manifestations, not only for the proper diagnosis, indication of patient isolation, as well as all the necessary biosafety procedures in dermatology clinics.    

scholarly journals Management of two taurodont primary molars with pulp involvement using calcium-enriched mixture cement pulpotomy in a patient with accompanied drug reaction with eosinophilia and systemic symptoms syndrome: a case report

2019 ◽  
Vol 6 (5) ◽  
pp. 3184-3188
Author(s):  
Sanaz Kamareh ◽  
Majid Kazem ◽  
Maryam Foroozandeh ◽  
Atefeh Gohari
Keyword(s):  
Drug Reaction ◽  
Pediatric Dentistry ◽  
Deciduous Teeth ◽  
Primary Molars ◽  
Dress Syndrome ◽  
Tooth Morphology ◽  
History Of ◽  
Deep Carious Lesions ◽  
School Of Dentistry ◽  
Systemic Symptoms

Background: Taurodontism is considered a variation in tooth morphology associated with several syndromes. Case Presentation: This report presents a case of taurodontism associated with drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. A 5-year-old girl, with a history of DRESS syndrome, was referred to the department of pediatric dentistry at the School of Dentistry, Shahid Beheshti University of Medical Sciences, with a chief complaint of toothache. Clinical and Radiographic examinations showed deep carious lesions with large pulp chambers and short roots present in relation to second mandibular primary molars. Routine pulpectomy could not be performed as a result of complex tooth morphology. Instead, we played a deep pulpotomy with calcium-enriched mixture cement agent, and the crowns were restored. Follow-up observations after six and 12 months showed that the tooth was asymptomatic, clinical and radiographic examinations revealed no swelling, no sensitivity to percussion and palpation. Conclusion: In patients with carious taurodont deciduous teeth, deep pulpotomy with biomaterials such as calcium-enriched mixture cement can result in favorable outcomes.  

scholarly journals Lamotrigine induced DRESS syndrome in a child: a case report and literature review

2021 ◽  
Author(s):  
Chien-Heng Lin ◽  
Sheng-Shing Lin ◽  
Syuan-Yu Hong ◽  
Chieh-Ho Chen ◽  
I-Ching Chou
Keyword(s):  
Drug Reaction ◽  
Case Report ◽  
Literature Review ◽  
Skin Rash ◽  
Anticonvulsant Drug ◽  
Dress Syndrome ◽  
Life Threatening ◽  
History Of ◽  
History Of Epilepsy ◽  
Systemic Symptoms

Abstract BackgroundLamotrigine is an important anticonvulsant drug. Its use, however, has been limited by the risk of potentially life-threatening dermatological reactions, such as drug reaction with eosinophilia and systemic symptoms (DRESS).Case presentationHere, we report the case of a 7-year-6-month-old girl with a history of epilepsy who developed a skin rash with dyspnoea after 2 weeks of lamotrigine treatment, with DRESS ultimately being diagnosed. After discontinuation of the offending drug and the initiation of systemic glucocorticosteroids, the DRESS symptoms were relieved and the patient was discharged in stable condition.ConclusionAnticonvulsant drugs such as lamotrigine among the factors that induce DRESS in children. When a patient displays skin rash and systemic organ involvement following the initiation of an anticonvulsant drug, DRESS should not be overlooked as a diagnosis, and immunosuppressant drugs should be considered as an option for treating DRESS patients.

scholarly journals A probable case of sodium valproate monotherapy induced drug reaction with eosinophilia and systemic symptoms syndrome: a case report in Indian population

2020 ◽  
Vol 9 (6) ◽  
pp. 991
Author(s):  
Vijayamathy Arunnair ◽  
Girish Kumaraswamy ◽  
Ramesh M.
Keyword(s):  
Drug Reaction ◽  
Bipolar Disorders ◽  
Maculopapular Rash ◽  
Hypersensitivity Syndrome ◽  
Dress Syndrome ◽  
Drug Induced ◽  
Probable Case ◽  
History Of ◽  
Systemic Symptoms ◽  
Generalized Lymphadenopathy

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a drug-induced hypersensitivity syndrome most commonly caused by anti-epileptics like carbamazepine, phenytoin. It usually manifests as maculopapular rash, fever, eosinophilia, generalized lymphadenopathy, hepatitis, atypical lymphocytosis, and leucocytosis with the involvement of other organs. Valproate, a broad-spectrum antiepileptic, also used in bipolar disorders and migraine prophylaxis, is generally well tolerated. To date, very few cases of valproate monotherapy induced DRESS syndrome have been reported worldwide and here we are reporting one such rare case in a 72 years old Indian woman with a history of generalised tonic convulsions. The patient was classified as a ‘probable’ case of DRESS syndrome using the WHO-UMC criteria and Naranjo scale. Discontinuation of the offending medication and treatment with intravenous (IV) fluids, antihistamines, and steroids helped in recovery of the patient. Healthcare practitioners must be aware of valproate monotherapy induced DRESS syndrome and take effective measures to avoid severe side effects. 

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