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Case Reports
. 2022 Apr;120(2):e80-e84.
doi: 10.5546/aap.2022.eng.e80. Epub 2022 Feb 4.

Valproic acid-induced DRESS in a child responding to cyclosporine with HLA analysis

[Article in Spanish, English]
Nazli Ercan  1 , Cengiz Zeybek  2 , Ayşe I Atasoy  3 , Bülent Unay  4
Affiliations
Free article
Case Reports

Valproic acid-induced DRESS in a child responding to cyclosporine with HLA analysis

[Article in Spanish, English]
Nazli Ercan et al. Arch Argent Pediatr. 2022 Apr.
Free article

Abstract
in English, Spanish

Drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug-induced hypersensitivity syndrome, is a potentially life-threatening rare reaction that causes a severe rash and can lead to multiorgan failure. As in other severe drug eruptions, drug-specific T lymphocytes play a crucial role in DRESS. The hapten/pro-hapten model, pharmacological interaction model, and altered peptide repertoire model are three different models developed to describe the relationship/interaction between a medication or its metabolites and the immune system. We discuss our experience with cyclosporine treatment in a steroid-resistant DRESS syndrome caused by valproic acid in a girl, as well as her clinical, laboratory, and human leukocyte antigens (HLA) study results.

El síndrome de erupción medicamentosa con eosinofilia y síntomas sistémicos (drug reaction with eosinophilia and systemic symptoms, DRESS), también conocido como síndrome de hipersensibilidad inducida por medicamentos, es una reacción rara potencialmente mortal que causa una erupción grave y que puede provocar insuficiencia multiorgánica. Como con otras erupciones medicamentosas graves, los linfocitos T específicos para un medicamento tienen una función crucial en el síndrome DRESS. El modelo de hapteno/pro-hapteno, el modelo de interacción farmacológica y el modelo alterado de repertorio de péptidos son tres modelos diferentes desarrollados para describir la relación/interacción entre un medicamento o sus metabolitos y el sistema inmunitario. Analizamos nuestra experiencia con el tratamiento con ciclosporina en un caso de síndrome DRESS resistente a esteroides causado por ácido valproico en una niña y sus resultados clínicos, de laboratorio y de antígeno leucocitario humano (HLA).

Keywords: HLA antigens; child; cyclosporine; drug hypersensitivity syndrome; valproic acid.

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References

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    1. Zhang ZX, Yang BQ, Yang Q, Wu M, Wang GJ. Treatment of drug-induced hypersensitivity syndrome with cyclosporine. Indian J Dermatol Venereol Leprol. 2017; 83(6):713-7.

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