Effects of IVIG and Pulse Steroid Therapy in a Case of Allopurinol Induced DRESS Syndrome

Selma Korkmaz; Elif Günay; Nuray Can; Sezin Fıçıcıoğlu; Süleyman Pişkin

doi:10.5152/EurJTher.2018.237

Authors

Selma Korkmaz Department of Dermatology, Süleyman Demirel University, School of Medicine, Isparta https://orcid.org/0000-0003-3877-3976
Elif Günay Clinic of Dermatology, Kaçkar State Hospital, Rize https://orcid.org/0000-0002-9943-0355
Nuray Can Department of Pathology, Trakya University, School of Medicine, Edirne https://orcid.org/0000-0003-2554-6432
Sezin Fıçıcıoğlu Department of Dermatology, Trakya University, School of Medicine, Edirne https://orcid.org/0000-0002-7934-3633
Süleyman Pişkin Department of Dermatology, Trakya University, School of Medicine, Edirne https://orcid.org/0000-0002-0999-2267

DOI:

https://doi.org/10.5152/EurJTher.2018.237

Keywords:

DRESS syndrome, allopurinol, pulse steroid

Abstract

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a drug reaction that causes peripheral eosinophilia and primarily renal and hepatic insufficiency and dysfunction of other visceral organs with skin rash as noticeable symptom. Early diagnosis and discontinuation of the culprit drug along with rapid treatment are required to reduce mortality rate. Herein, a case of allopurinol-induced DRESS syndrome is presented in which the patient was resistant to medium dose systemic steroid therapy and was treated with pulse steroid and IVIG treatment successfully. Pulse steroid therapy may be an alternative treatment option in refractory DRESS syndrome.

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References

Kardaun SH, Sekula P, Valeyrie -Allanore L, Liss Y, Chu CY, Creamer D, et al. RegiSCAR study group. Drug reaction with eosinophilia and systemic symptoms (DRESS): an original multisystem adevrse drug reaction. Results from the prospective RegiSCAR study. Br J Dermatol 2013; 169: 1071-80.

Bakkal SU, Tufan ZK, Bulut C, Boyraz S, Vahaboğlu G. A case of DRESS Syndrome mimicking Sepsis. Klimik Derg 2011; 24: 132-4.

Alkhateeb H, Said S, Cooper CJ, Gaur S, Porres-Aguilar M. DRESS syndrome following ciprofloxacin exposure: An unusual association. Am J Case Rep 2013; 4: 526-8.

Emre S, Akoğlu G, Metin A, Demirseren DD, Kurtoğlu G. Evaluation of clinical features of 11 cases with DRESS syndrome. Turkderm 2013; 47: 218-22.

Cacoub P, Musette P, Descamps V, Meyer O, Speirs C, Finzi L, Roujeau JC. The DRESS syndrome: a literature review. Am J Med 2011; 124: 588-97.

Erturan İ, Başak PY. A case of Allopurinol Induced Dress Syndrome. Turk J Dermatol 2013; 7: 100-2.

Guleria VS, Dhillon M, Gill S, Naithani NJ. Res Pharm Pract. Ceftriaxone induced drug rash with eosinophilia and systemic symptoms. 2014; 3: 72-4.

Singer JZ, Wallace SL. The allopurinol hypersensitivity syndrome. Unnecessary morbidity and mortality. Arthritis Rheum 1986;29:82-7.

Fernando SL. Drug-reaction eosinophilia and systemic symptoms and drug-induced hypersensitivity syndrome. Australas J Dermatol 2014; 55: 15-23.

Kito Y, Ito T, Tokura Y, Hashizume H. High-dose intravenous immunoglobulin monotherapy for drug-induced hypersensitivity syndrome. Acta Derm Venereol 2012; 92: 100-1.

Santhamoorthy P, Alexander KJ, Alshubaili A. Intravenous immunoglobulin in the treatment of drug rash eosinophilia and systemic symptoms caused by phenytoin. Ann Indian Acad Neurol 2012; 15: 320-2.

Dredge DC, Parsons EC, Carter LP, Staley KJ. Anticonvulsant hypersensitivity syndrome treated with intravenous immunoglobulin. Pediatr Neurol 2010; 43: 65-9.

Comfere NI, Sartori-Valinotti JC, Bruce AJ, Drage LA. Successful treatment of lamotrigine-associated drug hypersensitivity syndrome with intravenous IgG. J Am Acad Dermatol 2012; 66: 249-50.