Case Report: Alpelisib-Induced Drug Reaction With Eosinophilia and Systemic Symptoms: A Rare Manifestation of a Common Side Effect

Alpelisib is a PIK3a inhibitor approved for the treatment of metastatic ER+ breast cancer in combination with fulvestrant. Although rash is a common side effect of this medication, we present the first case of drug reaction with eosinophilia and systemic symptoms (DRESS) upon initial exposure to alpelisib. Here we describe the clinical-pathological findings and management of our patient with alpelisib-induced life-threatening DRESS syndrome. The goal of this case report is to highlight association of alpelisib with DRESS syndrome, in clinical practice, so that alpelisib can be immediately stopped and treatment for this serious condition promptly initiated.

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

Children ◽

10.3390/children8111063 ◽

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.

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Drug reaction with eosinophilia and systemic symptom induced by carbamazepine: a case report

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20191610 ◽

2019 ◽

Vol 8 (5) ◽

pp. 1115

Author(s):

Rahul R. Damor ◽

Amita R. Kubavat ◽

Kiran G. Piparva

Keyword(s):

Drug Reaction ◽

Case Report ◽

Antiepileptic Drugs ◽

Drug Exposure ◽

Latency Period ◽

Systemic Symptom ◽

Dress Syndrome ◽

Period 2 ◽

Life Threatening ◽

Systemic Symptoms

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, potentially life-threatening acute adverse drug reaction (ADR), typically characterized by a long latency period (2-6 weeks to 3 months) from drug exposure. DRESS syndrome is defined by the presence of fever, cutaneous eruption, lymphadenopathy, systemic or asymptomatic internal organ involvement (e.g. Hepatitis, carditis, interstitial nephritis, interstitial pneumonitis, etc.) and haematological abnormalities, mainly leucocytosis, eosinophilia and sometimes atypical lymphocytosis. There are around 50 culprit drugs which cause DRESS syndrome e.g. carbamazepine, phenytoin, allopurinol, sulfa derivatives, antidepressants, antiepileptics, non-steroidal anti-inflammatory drugs and antimicrobials. The incidence of DRESS syndrome has been estimated to be between 1 in 1,000 and 1 in 10,000 drug exposures. There are many reported cases of DRESS syndrome due to carbamazepine, phenytoin, vancomycin, levitiracitam, ceftriaxone etc. Author presented a case of DRESS syndrome by carbamazepin. RegiSCAR and Japanese consensus group have developed specific criteria for making the diagnosis of DRESS syndrome. The patient described here met the majority of criteria according to RegiSCAR scoring guidelines for a diagnosis of DRESS syndrome induced by carbamazepine. As per RegiSCAR diagnostic criteria author had concluded that this was a “Definite” case of DRESS (Drug Reaction with Eosinophilia and Systemic Symptom) syndrome induced by carbamazepine. Carbamazepine is most common broad-spectrum antiepileptic drugs so, this case report will raises awareness among physician to suspect DRESS syndrome in patients who present unusual complaints and skin findings after starting antiepileptic drugs.

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Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome induced by ceftriaxone with successful treatment — A case report and literature review

Indian Journal of Pharmacy and Pharmacology ◽

10.18231/j.ijpp.2021.053 ◽

2022 ◽

Vol 8 (4) ◽

pp. 298-300

Author(s):

Arpit Agrawal ◽

Pankaj Kannauje

Keyword(s):

Drug Reaction ◽

Case Report ◽

Literature Review ◽

Sore Throat ◽

Hypersensitivity Reactions ◽

Dress Syndrome ◽

Threatening Condition ◽

Life Threatening ◽

Systemic Symptoms ◽

Prolonged Latency

Drug reaction with eosinophilia and systemic symptoms is a rare and potentially life threatening condition characterised by hypersensitivity reactions to a drug with prolonged latency, in the form of skin rashes, hyper eosinophilia and systemic features like fever, lymphadenopathy, leucocytosis, internal organ involvement (liver, kidney, lung). Though it can occur in response to many drugs but very few cases has been described in relation to one of the most commonly used antibiotic ceftriaxone. Here we have described a case of DRESS in a patient who has been treated with ceftriaxone outside our hospital for sore throat.

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

10.21203/rs.3.rs-151612/v1 ◽

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.

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A Mysterious DRESS Case: Autoimmune Enteropathy Associated with DRESS Syndrome

Case Reports in Gastrointestinal Medicine ◽

10.1155/2017/7861857 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5

Author(s):

Abimbola Adike ◽

Vaishnavi Boppana ◽

Dora Lam-Himlin ◽

Melissa Stanton ◽

Steven Nelson ◽

...

Keyword(s):

Drug Reaction ◽

Gastrointestinal Tract ◽

Case Description ◽

Gastrointestinal Involvement ◽

Dress Syndrome ◽

Autoimmune Enteropathy ◽

First Case ◽

Cutaneous Hypersensitivity ◽

Life Threatening ◽

Systemic Symptoms

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a rare but potentially life-threatening cutaneous hypersensitivity reaction characterized by extensive mucocutaneous eruption, fever, hematologic abnormalities, and extensive organ involvement. Here, we present a case of a young woman with DRESS syndrome following exposure to vancomycin with renal, cutaneous, and gastrointestinal involvement. To the best of our knowledge, this is the first case description in the literature of DRESS of the gastrointestinal tract with autoimmune enteropathy.

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A Rare Presentation of Clozapine-Induced DRESS Syndrome

Case Reports in Medicine ◽

10.1155/2018/1346351 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 4

Author(s):

Carmel Moazez ◽

Yasir Rudha ◽

Natasha Narang ◽

Tina Younger

Keyword(s):

Bipolar Disorder ◽

Drug Reaction ◽

Side Effect ◽

Organ Involvement ◽

Past Medical History ◽

Dress Syndrome ◽

Rare Presentation ◽

First Case ◽

The Common ◽

Systemic Symptoms

Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome) is an uncommon side effect of certain medications. It causes a skin reaction, with eosinophilia and other organ involvement. This case describes a presentation of a 32-year-old female with a past medical history significant for schizophrenia and bipolar disorder who presented for a rash. She had been started on clozapine 10 days prior to admission. After extensive workup she was found to have DRESS syndrome secondary to clozapine use. This is the second reported case in the literature of clozapine-induced DRESS syndrome. This case is unique because it is the first case to present with the common manifestations of DRESS syndrome including eosinophilia, rash, lymphadenopathy, and organ involvement after clozapine use.

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Drug Rash With Eosinophilia and Systemic Symptoms (DRESS) Syndrome Probably Related to Cefpodoxime: A Case Report

Journal of Pharmacy Practice ◽

10.1177/0897190019866094 ◽

2019 ◽

pp. 089719001986609 ◽

Cited By ~ 1

Author(s):

Tirin Babu ◽

George Mathew Panachiyil ◽

Juny Sebastian ◽

Veeranna Shastry

Keyword(s):

Case Report ◽

Signs And Symptoms ◽

Side Effect Profile ◽

Drug Reactions ◽

Dress Syndrome ◽

First Case ◽

Drug History ◽

Drug Rash ◽

Systemic Symptoms ◽

Favorable Side Effect Profile

Cefpodoxime is a common antibiotic with a favorable side effect profile. Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome has been described with several cephalosporins but not cefpodoxime. We report the probable first case of cefpodoxime-induced DRESS syndrome in a 52-year-old female patient. In our case, the patient presented with symptoms of DRESS syndrome 16 days after initiation of cefpodoxime. This case highlights the necessity of consideration of an iatrogenic reason for presenting signs and symptoms at all times. Reinforcing the importance of taking a thorough drug history and considering drug reactions even if onset of symptoms are delayed.

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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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