A Rare Pediatric Case of Allopurinol-Induced Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Successfully Treated With Intravenous Immunoglobulins.

Q2 Medicine

Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2024-04-01 Epub Date: 2024-04-08 DOI:10.5863/1551-6776-29.2.195

Gioacchino Andrea Rotulo, Claudia Campanello, Marcella Battaglini, Marta Bassi, Carlotta Pastorino, Andrea Angeletti, Giacomo Brisca, Sara Signa, Roberta Caorsi, Gian Marco Ghiggeri

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引用次数: 0

Abstract

Allopurinol-induced drug reaction syndrome with eosinophilia and systemic symptoms (A-DRESS) is a well-described condition in adults, whereas it is uncommon among children. We describe a case of A-DRESS in a 16-year-old male with steroid-dependent nephrotic syndrome. He presented a life-threatening clinical course with persisting fever, skin rash, eosinophilia, lymphadenopathy, distributive shock, and herpesvirus 6 detection. The withdrawal of allopurinol and a combination of intravenous immunoglobulins (IVIGs) and systemic corticosteroids led to the patient's recovery without sequelae. Drug reaction with eosinophilia and systemic symptoms (DRESS) in pediatrics is rare and can present in a severe form. Early diagnosis and timely treatment are critical for prognostic purposes. This report suggests the potentially crucial role of IVIG in the treatment of patients with A-DRESS.

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用静脉注射免疫球蛋白成功治疗别嘌呤醇诱发的伴有嗜酸性粒细胞增多和全身症状的药物反应（DRESS）的罕见儿科病例。

别嘌呤醇诱导的伴有嗜酸性粒细胞增多和全身症状的药物反应综合征（A-DRESS）在成人中是一种常见病，而在儿童中并不常见。我们描述了一例患有类固醇依赖性肾病综合征的 16 岁男性 A-DRESS 病例。他的临床表现为持续发热、皮疹、嗜酸性粒细胞增多、淋巴结肿大、分布性休克和疱疹病毒 6 检测，危及生命。停用别嘌呤醇并联合使用静脉注射免疫球蛋白（IVIGs）和全身皮质类固醇后，患者康复，没有留下后遗症。儿科伴有嗜酸性粒细胞增多和全身症状的药物反应（DRESS）非常罕见，而且可能以严重的形式出现。早期诊断和及时治疗对预后至关重要。本报告提示了 IVIG 在治疗 A-DRESS 患者中的潜在关键作用。

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来源期刊

Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health

CiteScore

2.40

自引率

0.00%

发文量

期刊介绍： The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.