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Akut Hepatik Yetmezliğin Eşlik Ettiği DiHSS/ DRESS Sendromu Olgusu

Year 2023, Volume: 17 Issue: 5, 424 - 427, 25.09.2023
https://doi.org/10.12956/tchd.999501

Abstract

“Drug Induced Hypersensitivity Syndrome” (DiHS) ya da diğer adı ile “Drug Rash with Eoshinophilia and Systemic Symptoms” (DRESS) sendromu, yaşamı tehdit edebilen gecikmiş tip ilaç hipersensitivite reaksiyonudur. Ateş, deri döküntüsü, lenfadenopati, hematolojik anormallikler ve çoklu organ tutulumu ile karakterizedir. Karaciğer en sık tutulan organ olup, çoğunlukla karaciğer enzim yüksekliği ve akut anikterik hepatit şeklinde karşımıza çıkmaktadır. Çok daha nadir olarak kolestaz eşlik edebilir ve bu durum kötü prognoza işaret etmektedir. Bu yazıda valproik asit ilişkili hepatik yetmezlik ve ağır kolestazın görüldüğü DRESS sendromlu bir olgu sunulmuştur. İlaç kullanımı ile semptomların başlangıcı arasındaki sürenin uzun olması ve semptomların çeşitliliği nedeniyle DRESS sendromunun tanısında gecikmeler olabilmektedir. Hastalığın erken tanınması, morbidite ve mortaliteyi azaltmak açısından oldukça önem taşımaktadır.

Supporting Institution

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Project Number

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Thanks

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References

  • 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;15:250-7.
  • Shiohara T, Iijima M, Ikezawa Z, Hashimoto K. The diagnosis of a DRESS syndrome has been sufficiently established on the basis of typical clinical features and viral reactivations. Br J Dermatol 2007;156:1083-4.
  • 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.
  • Chen, YC, Cho YT, Chang CY, Chu CY. Drug reaction with eosinophilia and systemic symptoms: a drug-induced hypersensitivity syndrome with variable clinical features. Dermatologica Sinica 2013;31:196-204.
  • 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.
  • Criado PR, Criado RFJ, Avancini JM, Santi CG. Drug reaction with eosinophilia and systemic symptoms (DRESS)/ drug-induced hypersensitivity syndrome (DIHS): a review of current concepts. An Bras Dermatol 2012;87:435-49.
  • Cacoub P, Musette P, Descamps V, Meyer O, Speirs C, Finzi L, et al. The DRESS syndrome: a literature review. Am J Med 2011;124:588-97.
  • Shiohara T, Inaoka M, Kano Y. Drug-induced hypersensitivity syndrome (DIHS): a reaction induced by a complex interplay among herpesviruses and antiviral and antidrug immune responses. Allergol Int 2006;55:1-8.
  • Shiohara T, Kano Y, Takahashi R, Ishida T, Mizukawa Y.Drug-Induced Hypersensitivity Syndrome: Recent Advances in the Diagnosis, Pathogenesis and Management. In: French L.E (ed). Adverse Cutaneous Drug Eruptions. 1st ed. Basel: Kargel, 2012:122-38.
  • Kano Y, Shiohara T. The variable clinical picture of drug-induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms in relation to the eliciting drug. Immunol Allergy Clin North Am 2009;29:481-501.
  • Martinez-Cabriales SA, Shear NH, Gonzalez-Moreno EI. Liver involvement in the drug reaction, eosinophilia, and systemic symptoms syndrome. World J Clin Cases 2019;7:705-16.
  • Husain Z, Reddy BY, Schwartz RA. DRESS syndrome: Part II. Management and therapeutics. J Am Acad Dermatol 2013;68:709.e1-9.
  • Moling O, Tappeiner L, Piccin A, Pagani E, Rossi P, Rimenti G, et al. Treatment of DIHS/DRESS syndrome with combined N-acetylcysteine, prednisone and valganciclovir--a hypothesis. Med Sci Monit 2012;18:CS57-62.
  • Barbaud A, Collet E, Milpied B, Assier H, Staumont D, Avenel-Audran M, et al. A multicentre study to determine the value and safety of drug patch tests for the three main classes of severe cutaneous adverse drug reactions. Br J Dermatol 2013;168:555-62.

A Case of DiHSS/DRESS Syndrome-Related Acute Hepatic Failure

Year 2023, Volume: 17 Issue: 5, 424 - 427, 25.09.2023
https://doi.org/10.12956/tchd.999501

Abstract

‘Drug Induced Hypersensitivity Syndrome’ (DiHS) or ‘Drug Rash with Eosinophilia and Systemic Symptoms’ (DRESS) syndrome is a life threatening, delayed type drug hypersensitivity reaction. This syndrome is characterized by fever, skin rash, lymphadenopathy, hematological abnormalities and visceral involvement and liver is the most frequently involved visceral organ. Liver involvement is mostly presented as acute anicteric hepatitis with elevated liver enzymes. Rarely, it can be presented as cholestasis which indicates a worse prognosis. In this article, a case of valproic acid induced-DRESS syndrome who presented with acute hepatic failure is presented. Diagnosis of DRESS syndrome may delay due to the long interval between drug intake and the onset of symptoms. The variety of symptoms can also be challenging. Early diagnosis is important in terms of reducing morbidity and mortality.

Project Number

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References

  • 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;15:250-7.
  • Shiohara T, Iijima M, Ikezawa Z, Hashimoto K. The diagnosis of a DRESS syndrome has been sufficiently established on the basis of typical clinical features and viral reactivations. Br J Dermatol 2007;156:1083-4.
  • 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.
  • Chen, YC, Cho YT, Chang CY, Chu CY. Drug reaction with eosinophilia and systemic symptoms: a drug-induced hypersensitivity syndrome with variable clinical features. Dermatologica Sinica 2013;31:196-204.
  • 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.
  • Criado PR, Criado RFJ, Avancini JM, Santi CG. Drug reaction with eosinophilia and systemic symptoms (DRESS)/ drug-induced hypersensitivity syndrome (DIHS): a review of current concepts. An Bras Dermatol 2012;87:435-49.
  • Cacoub P, Musette P, Descamps V, Meyer O, Speirs C, Finzi L, et al. The DRESS syndrome: a literature review. Am J Med 2011;124:588-97.
  • Shiohara T, Inaoka M, Kano Y. Drug-induced hypersensitivity syndrome (DIHS): a reaction induced by a complex interplay among herpesviruses and antiviral and antidrug immune responses. Allergol Int 2006;55:1-8.
  • Shiohara T, Kano Y, Takahashi R, Ishida T, Mizukawa Y.Drug-Induced Hypersensitivity Syndrome: Recent Advances in the Diagnosis, Pathogenesis and Management. In: French L.E (ed). Adverse Cutaneous Drug Eruptions. 1st ed. Basel: Kargel, 2012:122-38.
  • Kano Y, Shiohara T. The variable clinical picture of drug-induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms in relation to the eliciting drug. Immunol Allergy Clin North Am 2009;29:481-501.
  • Martinez-Cabriales SA, Shear NH, Gonzalez-Moreno EI. Liver involvement in the drug reaction, eosinophilia, and systemic symptoms syndrome. World J Clin Cases 2019;7:705-16.
  • Husain Z, Reddy BY, Schwartz RA. DRESS syndrome: Part II. Management and therapeutics. J Am Acad Dermatol 2013;68:709.e1-9.
  • Moling O, Tappeiner L, Piccin A, Pagani E, Rossi P, Rimenti G, et al. Treatment of DIHS/DRESS syndrome with combined N-acetylcysteine, prednisone and valganciclovir--a hypothesis. Med Sci Monit 2012;18:CS57-62.
  • Barbaud A, Collet E, Milpied B, Assier H, Staumont D, Avenel-Audran M, et al. A multicentre study to determine the value and safety of drug patch tests for the three main classes of severe cutaneous adverse drug reactions. Br J Dermatol 2013;168:555-62.
There are 14 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section CASE REPORTS
Authors

Şeyma Özpınar This is me 0000-0001-5121-8542

Özlem Kalaycık Şengül 0000-0001-9594-5231

Emine Bilge Aydın This is me 0000-0002-2759-6989

Burçin Beken 0000-0001-7677-7690

Project Number -
Early Pub Date May 3, 2023
Publication Date September 25, 2023
Submission Date September 23, 2021
Published in Issue Year 2023 Volume: 17 Issue: 5

Cite

Vancouver Özpınar Ş, Kalaycık Şengül Ö, Aydın EB, Beken B. A Case of DiHSS/DRESS Syndrome-Related Acute Hepatic Failure. Türkiye Çocuk Hast Derg. 2023;17(5):424-7.


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