DRESS Syndrome After Phenytoin Use: A Case Report

Abstract

DRESS syndrome is alife threatening, rare  hypersensitivity reaction to drugs with an acute onset that is characterized by fever, skin rash, visceral involvement, and hematological abnormalities. It is often seen after the use of aromatic anticonvulsants. In this article, a forty-four year old male patient with fever and skin rash after two weeks of phenytoin administration is discussed. He has been treated successfully with systemic corticosteroids and supportive therapy after the discontinuation of phenytoin therapy. In first step health-care, the primary physician should be able to administer his patients’ acute and chronic health problems concurrently. As in our case, a family physician should administer his patient well in the presence of fever with acute onset and he should question about the drugs used in the presence of accompanying skin rash.

Keywords

• DRESS syndrome,phenytoin,skin rash

Fenitoin Kullanımı Sonrası Gelişen DRESS Sendromu: Olgu Sunumu

Öz

DRESS Sendromu ateş, cilt döküntüsü, iç organ tutulumu ve hematolojik anormalliklerle karakterize akut başlangıçlı, hayatı tehdit eden, nadir görülen, ilaca bağlı bir aşırı duyarlılık reaksiyonudur. En sık nedeni aromatik antikonvülzan kullanma sonrası görülmektedir. Bu olguda fenitoin kullanımı sonrasında ikinci haftada ateş yüksekliği ve cilt döküntüleri başlayan kırk dört yaşında bir erkek hasta sunulmuştur.  Olgu, fenitoin tedavisinin kesilmesi sonrasında sistemik kortikosteroid ve destek tedavisi ile başarılı bir şekilde tedavi edilebilmiştir. Birinci basamakta aile hekimi, hastalarının akut ve kronik sağlık sorunlarını aynı anda yönetebilmelidir. Olgumuzda olduğu gibi akut başlangıçlı ateşe yaklaşımda bir aile hekimi hastasını iyi yönetebilmeli ve beraberinde cilt döküntüleri de gördüğünde kullandığı ilaçları da sorgulayarak DRESS Sendromunu akla getirmelidir.

Anahtar Kelimeler

• DRESS sendromu,fenitoin,cilt döküntüsü

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