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. 2020 Sep;20(3):2377-2380.
doi: 10.3892/etm.2020.8894. Epub 2020 Jun 17.

Severe DRESS syndrome after carbamazepine intake in a case with multiple addictions: A case report

Daniela Vrinceanu  1 , Mihai Dumitru  2 , Adrian Stefan  1 , Adriana Neagos  3 , Gabriela Musat  4 , Elena Adriana Nica  5
Affiliations

Severe DRESS syndrome after carbamazepine intake in a case with multiple addictions: A case report

Daniela Vrinceanu et al. Exp Ther Med. 2020 Sep.

Abstract

A case is presented of a male with drug rash with eosinophilia and systemic symptoms (DRESS) syndrome induced by carbamazepine intake. The patient presented all the elements of DRESS syndrome: Skin reaction, fever, enlargement of the lymph nodes, increased eosinophils and lymphocytes, with associated organ dysfunctions. The patient was admitted with acute laryngeal edema and imminence of respiratory insufficiency. The escalation of symptoms for this syndrome is typical, even after the administering of the the culprit medicine has ceased. However, in this case, the most difficult aspect was the complex treatment scheme prior to admission. All medical compounds involved in the background treatment were substituted with other substances in order to control the immune response. Current knowledge regarding DRESS is reviewed and possible influence of various etiologies over the present case are discussed. Clinicians should be aware of this rare situation with life-threatening potential. We benefited from the advantage of reuniting the knowledge of a complex team of experts from various tertiary emergency units in Romania.

Keywords: DRESS syndrome; addiction; carbamazepine; eosinophilia; respiratory distress.

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Figures

Figure 1
Figure 1
Case images on admission: Dorsal, axillar, palmar skin eruption without migration on the body; oral enanthem and edema with impaired breathing.
Figure 2
Figure 2
Chest X-ray; frontal and lateral view revealing accentuated basal interstitial accumulation of edema.
Figure 3
Figure 3
Neck CT scans in sagittal and axial planes, showing the presence of reactive lymph nodes and the laryngeal edema with imminent respiratory distress.
See this image and copyright information in PMC

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