medigraphic.com
ISSN 1405-1699 (Print)
Órgano Oficial del Colegio Mexicano de Alergia, Asma e Inmunología Pediátrica y de la Asociación Latinoamericana de Pediatría

2022, Number 2

<< Back Next >>

Alerg Asma Inmunol Pediatr 2022; 31 (2)

Carbamazepine-induced DRESS syndrome: a severe delayed hypersensitivity reaction

Bonilla-Bustos AB, Moribe-Quintero IC, Gómez-Urrego JF

Language: Spanish
References: 33
Page: 51-57
PDF size: 226.38 Kb.


ABSTRACT

Drug reaction syndrome with eosinophilia and systemic symptoms (DRESS) is classified as a severe and potentially life-threatening type IVb hypersensitivity reaction, which occurs after exposure to drugs mainly aromatic anticonvulsants, allopurinol and some antimicrobial agents. Its incidence in children is not really known, but is estimated at 1/1,000-10,000 patients exposed to the drug. Mortality is documented at approximately 10%. The precise pathogenesis of DRESS remains unclear, however, in recent years it has been postulated that it is the result of the interaction of the following factors: pharmacogenetic, infection or reactivation of certain viruses, mainly human herpes virus 6 and 7, cytomegalovirus (CMV) and Epstein-Barr (EBV) and immunological. The classic clinical presentation includes fever preceded by a morbilliform rash, hematological alterations and internal organ involvement. The most common visceral organ involved is the liver. The onset of symptoms is usually delayed, ranging from two to eight weeks after initiation of treatment with the triggering drug. Immediate discontinuation of the offending drug and initiation of corticosteroids are the mainstay of treatment. We describe the clinical case of a 14-year-old female patient with carbamazepine-induced DRESS syndrome evaluated with the European Registry of Severe Cutaneous Adverse Reactions (RegiSCAR) as a "probable case" with difficulty in establishing the diagnosis due to the heterogeneity of the clinical manifestations observed; once confirmation was achieved, the evolution was satisfactory.


REFERENCES

  1. Sharifzadeh S, Mohammadpour AH, Tavanaee A, Elyasi S. Antibacterial antibiotic-induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome: a literature review. Eur J Clin Pharmacol. 2021; 77 (3): 275-289.

  2. Husain Z, Reddy BY, Schwartz RA. DRESS syndrome: Part I. Clinical perspectives. J Am Acad Dermatol. 2013; 68 (5): 693.e1-14; quiz 706-708.

  3. Bocquet H, Bagot M, Roujeau JC. Drug-induced pseudolymphoma and drug hypersensitivity syndrome (Drug Rash with Eosinophilia and Systemic Symptoms: DRESS). Semin Cutan Med Surg. 1996; 15 (4): 250-257.

  4. Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM, Greenberger PA et al. International Consensus on Drug Allergy. Allergy. 2014; 69 (4): 420-437.

  5. Porto Arceo JA. Reacciones adversas a medicamentos. Generalidades. Criterios de derivación. Protoc Diagn Ter Pediatr. 2019; 2: 285-295.

  6. de Pediatría SA, Subcomisiones C. Reacciones alérgicas a betalactámicos en pediatría: recomendaciones para su diagnóstico y tratamiento. Arch Argent Pediatr. 2019; 117 (Supl 1): S24-S36.

  7. Kardaun SH, Sekula P, Valeyrie-Allanore L, Liss Y, Chu CY, Creamer D et al. Drug reaction with eosinophilia and systemic symptoms (DRESS): an original multisystem adverse drug reaction. Results from the prospective RegiSCAR study. Br J Dermatol. 2013; 169 (5): 1071-1080.

  8. Cacoub P, Musette P, Descamps V, Meyer O, Speirs C, Finzi L et al. The DRESS syndrome: a literature review. Am J Med. 2011; 124 (7): 588-597.

  9. Girelli F, Bernardi S, Gardelli L, Bassi B, Parente G, Dubini A et al. A New case of DRESS syndrome induced by sulfasalazine and triggered by amoxicillin. Case Rep Rheumatol. 2013; 2013: 409152.

  10. Burlui A, Cardoneanu A, Macovei L, Rezus E. When rheumatoid arthritis also affects the skin (PART IV: Drug-related adverse reactions and other cutaneous changes). Rev Med Chir Soc Med Nat. 2020; 124 (3): 72-81.

  11. Phillips EJ, Bigliardi P, Bircher AJ, Broyles A, Chang YS, Chung WH et al. Controversies in drug allergy: testing for delayed reactions. J Allergy Clin Immunol. 2019; 143 (1): 66-73.

  12. Yun J, Adam J, Yerly D, Pichler WJ. Human leukocyte antigens (HLA) associated drug hypersensitivity: consequences of drug binding to HLA. Allergy. 2012; 67 (11): 1338-1346.

  13. Lanz J, Bavinck JNB, Westhuis M, Quint KD, Harwood CA, Nasir S et al. Aggressive squamous cell carcinoma in organ transplant recipients. JAMA Dermatol. 2019; 155 (1): 66-71.

  14. Pavlos R, White KD, Wanjalla C, Mallal SA, Phillips EJ. Severe delayed drug reactions: role of genetics and viral infections. Immunol Allergy Clin. 2017; 37 (4): 785-815.

  15. Pirmohamed M, Graham A, Roberts P, Smith D, Chadwick D, Breckenridge AM et al. Carbamazepine hypersensitivity: assessment of clinical and in vitro chemical cross reactivity with phenytoin and oxcarbazepine. Br J Clin Pharmacol. 1991; 32 (6): 741-749.

  16. Descamps V, Ben Said B, Sassolas B, Truchetet F, Avenel-Audran M, Girardin P et al. Prise en charge du drug reaction with eosinophilia and systemic symptoms (DRESS). Ann Dermatol Venereol. 2010; 137 (11): 703-708.

  17. Hamm RL. Drug-hypersensitivity syndrome: diagnosis and treatment. J Am Coll Clin Wound Spec. 2011; 3 (4): 77-81.

  18. Santiago F, Goncalo M, Vieira R, Coelho S, Figueiredo A. Epicutaneous patch testing in drug hypersensitivity syndrome (DRESS). Contact Dermatitis. 2010; 62 (1): 47-53.

  19. Yoshikawa T, Fujita A, Yagami A, Suzuki K, Matsunaga K, Ihira M et al. Human herpesvirus 6 reactivation and inflammatory cytokine production in patients with drug-induced hypersensitivity syndrome. J Clin Virol. 2006; 37: S92-S96.

  20. Swanson L, Colven RM. Approach to the patient with a suspected cutaneous adverse drug reaction. Med Clin. 2015; 99 (6): 1337-1348.

  21. Cabañas R, Ramírez E, Sendagorta E, Alamar R, Barranco R, Blanca-López N et al. Spanish guidelines for diagnosis, management, treatment, and prevention of DRESS syndrome. J Investig Allergol Clin Immunol. 2020; 30 (4): 229-253.

  22. Lin IC, Yang HC, Strong C, Yang CW, Cho YT, Chen KL et al. Liver injury in patients with DRESS: a clinical study of 72 cases. J Am Acad Dermatol. 2015; 72 (6): 984-991.

  23. Mennicke M, Zawodniak A, Keller M, Wilkens L, Yawalkar N, Stickel F et al. Fulminant liver failure after vancomycin in a sulfasalazine induced DRESS syndrome: fatal recurrence after liver transplantation. Am J Transplant. 2009; 9 (9): 2197-2202.

  24. Kumari R, Timshina D, Thappa D. Drug hypersensitivity syndrome. Indian J Dermatol Venereol Leprol. 2011; 77 (1): 7-15.

  25. Watanabe H. Recent advances in drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms. J Immunol Res. 2018; 2018: 5163129.

  26. Gentile I, Talamo M, Borgia G. Is the drug-induced hypersensitivity syndrome (DIHS) due to human herpesvirus 6 infection or to allergy-mediated viral reactivation? Report of a case and literature review. BMC Infect Dis. 2010; 10: 49.

  27. Kato M, Kano Y, Sato Y, Shiohara T. Severe agranulocytosis in two patients with drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms. Acta Derm Venereol. 2016; 96 (6): 842-843.

  28. Ortonne N, Valeyrie-Allanore L, Bastuji-Garin S, Wechsler J, de Feraudy S, Duong TA et al. Histopathology of drug rash with eosinophilia and systemic symptoms syndrome: a morphological and phenotypical study. Br J Dermatol. 2015; 173 (1): 50-58.

  29. McCrindle BW, Rowley AH, Newburger JW, Burns JC, Bolger AF, Gewitz M et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 2017; 135 (17): e927-e999.

  30. Fernandez-Juarez G, Perez JV, Caravaca-Fontán F, Quintana L, Shabaka A, Rodriguez E et al. Duration of treatment with corticosteroids and recovery of kidney function in acute interstitial nephritis. Clin J Am Soc Nephrol. 2018; 13 (12): 1851-1858.

  31. Londoño-Arcila HF, Guerra-Pabón MA, Hernández-Revelo CD, Hoyos-Samboni DF, Jiménez-Orrego KV. Anticonvulsivantes inducen síndrome de reacción a drogas con eosinofília y síntomas sistémicos (DRESS) con falla hepática fulminante. Rev Fac Med. 2017; 65 (1): 165-168.

  32. Joly P, Janela B, Tetart F, Rogez S, Picard D, D'Incan M et al. Poor benefit/risk balance of intravenous immunoglobulins in DRESS. Arch Dermatol. 2012; 148 (4): 543-544.

  33. Laban E, Hainaut-Wierzbicka E, Pourreau F, Yacoub M, Sztermer E, Guillet G et al. Cyclophosphamide therapy for corticoresistant drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome in a patient with severe kidney and eye involvement and Epstein-Barr virus reactivation. Am J Kidney Dis. 2010; 55 (3): e11-4. doi: 10.1053/j.ajkd.2009.10.054.




2020     |     www.medigraphic.com