A New Case of DRESS Syndrome Induced by Sulfasalazine and Triggered by Amoxicillin
Drug Rash Eosinophilia Systemic Symptoms (DRESS) syndrome is a systemic hypersensitivity reaction characterized by exfoliative dermatitis and maculopapular rash, lymphadenopathy, fever, eosinophilia, leukocytosis, and involvement of internal organs as liver, lung, heart, and kidney; the disorder sta...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Rheumatology |
| Online Access: | http://dx.doi.org/10.1155/2013/409152 |
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| author | Francesco Girelli Simone Bernardi Lucia Gardelli Bruna Bassi Gianluca Parente Alessandra Dubini Luigi Serra Maurizio Nizzoli |
| author_facet | Francesco Girelli Simone Bernardi Lucia Gardelli Bruna Bassi Gianluca Parente Alessandra Dubini Luigi Serra Maurizio Nizzoli |
| author_sort | Francesco Girelli |
| collection | DOAJ |
| description | Drug Rash Eosinophilia Systemic Symptoms (DRESS) syndrome is a systemic hypersensitivity reaction characterized by exfoliative dermatitis and maculopapular rash, lymphadenopathy, fever, eosinophilia, leukocytosis, and involvement of internal organs as liver, lung, heart, and kidney; the disorder starts within 2–6 weeks after taking a drug with an incidence that ranges from 1/1000 to 1/10000 exposures. Fatal cases are reported. The exact pathogenesis of DRESS syndrome is not completely understood, while it is reported that amoxicillin could trigger it in patients who are taking allopurinol, sulfasalazine, NSAIDs, carbamazepine, strontium ranelate, lisinopril, lansoprazole, and minocycline. Amoxicillin could act directly, inducing the reactivation of a viral infection (HHV 6 and EBV) with symptoms similar to DRESS syndrome or by reducing the patients’ ability to detoxify the body from substances chronically taken. We describe a case of a patient admitted to our hospital for a DRESS syndrome flared after amoxicilline intake during treatment with sulfasalazine; this combination can activate severe reactions often with an insidious onset that can mimic an infectious disease. |
| format | Article |
| id | doaj-art-488bfb8ec2d94a19bf794d2bd47d747f |
| institution | Kabale University |
| issn | 2090-6889 2090-6897 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Rheumatology |
| spelling | doaj-art-488bfb8ec2d94a19bf794d2bd47d747f2025-02-03T06:07:54ZengWileyCase Reports in Rheumatology2090-68892090-68972013-01-01201310.1155/2013/409152409152A New Case of DRESS Syndrome Induced by Sulfasalazine and Triggered by AmoxicillinFrancesco Girelli0Simone Bernardi1Lucia Gardelli2Bruna Bassi3Gianluca Parente4Alessandra Dubini5Luigi Serra6Maurizio Nizzoli7Internal Medicine Department, Rheumatology Unit, G.B. Morgagni Hospital, Via Forlanini 34, 47121 Forlì, ItalyInternal Medicine Department, Rheumatology Unit, G.B. Morgagni Hospital, Via Forlanini 34, 47121 Forlì, ItalyInternal Medicine Department, Rheumatology Unit, G.B. Morgagni Hospital, Via Forlanini 34, 47121 Forlì, ItalyInternal Medicine Department, Rheumatology Unit, G.B. Morgagni Hospital, Via Forlanini 34, 47121 Forlì, ItalyDermatology Unit, G.B. Morgagni Hospital, Via Forlanini 34, 47121 Forlì, ItalyPathology Unit, G.B. Morgagni Hospital, Via Forlanini 34, 47121 Forlì, ItalyPathology Unit, G.B. Morgagni Hospital, Via Forlanini 34, 47121 Forlì, ItalyInternal Medicine Department, Rheumatology Unit, G.B. Morgagni Hospital, Via Forlanini 34, 47121 Forlì, ItalyDrug Rash Eosinophilia Systemic Symptoms (DRESS) syndrome is a systemic hypersensitivity reaction characterized by exfoliative dermatitis and maculopapular rash, lymphadenopathy, fever, eosinophilia, leukocytosis, and involvement of internal organs as liver, lung, heart, and kidney; the disorder starts within 2–6 weeks after taking a drug with an incidence that ranges from 1/1000 to 1/10000 exposures. Fatal cases are reported. The exact pathogenesis of DRESS syndrome is not completely understood, while it is reported that amoxicillin could trigger it in patients who are taking allopurinol, sulfasalazine, NSAIDs, carbamazepine, strontium ranelate, lisinopril, lansoprazole, and minocycline. Amoxicillin could act directly, inducing the reactivation of a viral infection (HHV 6 and EBV) with symptoms similar to DRESS syndrome or by reducing the patients’ ability to detoxify the body from substances chronically taken. We describe a case of a patient admitted to our hospital for a DRESS syndrome flared after amoxicilline intake during treatment with sulfasalazine; this combination can activate severe reactions often with an insidious onset that can mimic an infectious disease.http://dx.doi.org/10.1155/2013/409152 |
| spellingShingle | Francesco Girelli Simone Bernardi Lucia Gardelli Bruna Bassi Gianluca Parente Alessandra Dubini Luigi Serra Maurizio Nizzoli A New Case of DRESS Syndrome Induced by Sulfasalazine and Triggered by Amoxicillin Case Reports in Rheumatology |
| title | A New Case of DRESS Syndrome Induced by Sulfasalazine and Triggered by Amoxicillin |
| title_full | A New Case of DRESS Syndrome Induced by Sulfasalazine and Triggered by Amoxicillin |
| title_fullStr | A New Case of DRESS Syndrome Induced by Sulfasalazine and Triggered by Amoxicillin |
| title_full_unstemmed | A New Case of DRESS Syndrome Induced by Sulfasalazine and Triggered by Amoxicillin |
| title_short | A New Case of DRESS Syndrome Induced by Sulfasalazine and Triggered by Amoxicillin |
| title_sort | new case of dress syndrome induced by sulfasalazine and triggered by amoxicillin |
| url | http://dx.doi.org/10.1155/2013/409152 |
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