DRESS Syndrome: A Review Based on a Clinical Report
DOI:
https://doi.org/10.24950/rspmi.2353Palavras-chave:
Drug Hypersensitivity Syndrome, Exanthema, Postpartum PeriodResumo
DRESS syndrome is a rare but potentially life-threatening disease that may present with multiorgan involvement and cutaneous eruptions.
We report the case of a 28-year-old puerperal woman who developed a cutaneous exanthema 2 months after cesarean delivery, along with muscle pain, odynophagia, cough, and fever. The cutaneous eruption started on the lower limbs and
progressed throughout the entire body. The patient had received ceftriaxone intravenously during delivery and had a history of oral intake of diclofenac and methyldopa. Scored 6 on RegiSCAR,
confirming the diagnosis of DRESS syndrome. The
patient also developed toxic hepatitis, which was managed with intravenous corticotherapy. After 2 weeks of treatment and the removal of probable drugs, the patient was discharged with clinical and laboratory improvement.
This case highlights the importance of prompt diagnosis
and treatment of late pharmacological reactions, particularly
DRESS Syndrome, which can be challenging to diagnose due
to its delayed presentation.
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Referências
Taweesedt PT, Nordstrom CW, Stoeckel J, Dumic I. Pulmonary manifestations of drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome: A systematic review. Biomed Res Int. 2019;2019:7863815. doi: 10.1155/2019/7863815.
Isaacs M, Cardones AR, Rahnama-Moghadam S. DRESS syndrome: clinical myths and pearls. Cutis. 2018;102:322-6.
Mockenhaupt MP. Drug reaction with eosinophilia and systemic symptoms (DRESS). UpToDate. [accessed May 2023] Available from: http://www.uptodate.com/contents/drug-reaction-with-eosinophilia-and-systemic-
-symptoms-DRESS
Descamps V, Ranger-Rogez S. DRESS syndrome. Joint Bone Spine. 2014;81:15-21. doi: 10.1016/j.jbspin.2013.05.002.
Kardaun SH, Sidoroff A, Valeyrie-Allanore L, Halevy S, Davidovici BB, Mockenhaupt M, et al. Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist? Br J Dermatol. 2007;156:609-11. doi: 10.1111/j.1365-2133.2006.07704.x.
Cho YT, Yang CW, Chu CY. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): An Interplay among Drugs, Viruses, and Immune System. Int J Mol Sci. 2017;18:1243. doi: 10.3390/ijms18061243.
Silva SA, Figueiredo MM, Carneiro L Neto, Reiss DB, Damásio MA. Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome). Rev Assoc Med Bras. 2016;62:227-30. doi: 10.1590/1806-9282.62.03.227.
Walsh S, Diaz-Cano S, Higgins E, Morris-Jones R, Bashir S, Bernal W, Creamer D. Drug reaction with eosinophilia and systemic symptoms: is cutaneous phenotype a prognostic marker for outcome? A review of clinicopathological
features of 27 cases. Br J Dermatol. 2013;168:391-401. doi: 10.1111/bjd.12081.
Snyder LM. Wallach's Interpretation of Diagnostic Tests. Alphen aan den Rijn: Lippincott Williams & Wilkins;2020.
Shiohara T, Mizukawa Y. Drug-induced hypersensitivity syndrome (DiHS)/ drug reaction with eosinophilia and systemic symptoms (DRESS): An update in 2019. Allergol Int. 2019;68:301-8. doi: 10.1016/j.alit.2019.03.006.
Descamps V, Bouscarat F, Laglenne S, Aslangul E, Veber B, Descamps D, et al. Human herpesvirus 6 infection associated with anticonvulsant hypersensitivity syndrome and reactive haemophagocytic syndrome. Br J Dermatol. 1997;137:605-8. doi: 10.1111/j.1365-2133.1997.tb03795.x.
Tohyama M, Yahata Y, Yasukawa M, Inagi R, Urano Y, Yamanishi K, et al. Severe hypersensitivity syndrome due to sulfasalazine associated with reactivation of human herpesvirus 6. Arch Dermatol. 1998;134:1113-7. doi: 10.1001/archderm.134.9.1113.
Suzuki Y, Inagi R, Aono T, Yamanishi K, Shiohara T. Human herpesvirus 6 infection as a risk factor for the development of severe drug-induced hypersensitivity syndrome. Arch Dermatol. 1998;134:1108-12. doi: 10.1001/archderm.134.9.1108.
De A, Rajagopalan M, Sarda A, Das S, Biswas P. Drug Reaction with Eosinophilia and Systemic Symptoms: An Update and Review of Recent Literature. Indian J Dermatol. 2018;63:30-40. doi: 10.4103/ijd.IJD_582_17.
Adwan MH. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome and the Rheumatologist. Curr Rheumatol Rep. 2017;19:3. doi: 10.1007/s11926-017-0626-z.

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