Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome with Multiple Drugs (Leflunomide and Cefuroxime): A Case Report.

IF 1.1 Q4 PHARMACOLOGY & PHARMACY
Pooja Yadav, Gopal Krishna Rao, Padmanabh V Rataboli, Shailendra S Gurav
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引用次数: 0

Abstract

Background: Adverse Drug Reactions (ADRs) are unexpected reactions to a medicine administered in the correct manner and at the proper dosage. Drug Rash with Eosinophilia and Systemic Symptoms syndrome (DRESS syndrome) is a Severe Cutaneous Adverse Reaction (SCAR) type of ADR with complicated clinical features involving several organ systems of the body; frequently involved organs are the liver, kidney, lungs, and other organs. Prompt recognition and correct diagnosis, followed by withdrawal of the causative agent, can promote appropriate treatment, accelerate recovery, and reduce the related morbidity and mortality.

Case presentation: We have, herein, presented a case of a 42-year-old female with a history of leflunomide intake for plantar fasciitis. The patient subsequently developed fever, gastrointestinal tract disturbance, facial edema, liver injury, skin rash, hematologic abnormalities (eosinophilia), hepatosplenomegaly, and lymph node enlargement. The probability of leflunomide-induced DRESS syndrome was rated as "definite", with seven scores graded by RegiSCAR. The suspected causative agent was withdrawn, and the patient was managed symptomatically. Following her management and discharge, she again encountered similar complaints after administration of the cefuroxime tablet. The causality assessment of the reactions was done using the WHO-UMC scale and Naranjo's assessment scale, and a "probable" reaction was found for both drugs.

Conclusion: The presented case contributes to the existing global literature regarding exceptional clinical presentations. Leflunomide and cefuroxime drugs have the potential to cause DRESS syndrome. Thus, they should be handled cautiously, and if such a reaction occurs, it should be reported to the responsible authorities.

多种药物(来氟米特和头孢呋辛)引起的嗜酸性粒细胞增多和全身症状(DRESS)药物反应综合征:病例报告。
背景:药物不良反应(ADRs)是指以正确的方式和剂量用药后出现的意外反应。药疹伴嗜酸性粒细胞增多和全身症状综合征(DRESS 综合征)是一种严重皮肤不良反应(SCAR)类型的 ADR,临床特征复杂,涉及人体多个器官系统,常累及的器官有肝、肾、肺和其他器官。及时识别和正确诊断,然后停用致病剂,可以促进适当的治疗,加快康复,降低相关的发病率和死亡率:我们在此提供了一例 42 岁女性的病例,她曾因足底筋膜炎服用来氟米特。患者随后出现发热、胃肠道功能紊乱、面部水肿、肝损伤、皮疹、血液学异常(嗜酸性粒细胞增多)、肝脾肿大和淋巴结肿大。来氟米特诱发 DRESS 综合征的可能性被评为 "确定",RegiSCAR 对其进行了七级评分。患者停用了疑似致病药物,并接受了对症治疗。出院后,她在服用头孢呋辛片后再次出现类似症状。使用世界卫生组织-联合国军医组织量表和纳兰霍评估量表对这些反应进行了因果关系评估,结果发现两种药物都有 "可能 "发生反应:结论:本病例为有关特殊临床表现的现有全球文献做出了贡献。来氟米特和头孢呋辛类药物有可能导致 DRESS 综合征。因此,应谨慎使用这两种药物,如果出现这种反应,应向有关部门报告。
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来源期刊
Current drug safety
Current drug safety PHARMACOLOGY & PHARMACY-
CiteScore
2.10
自引率
0.00%
发文量
112
期刊介绍: Current Drug Safety publishes frontier articles on all the latest advances on drug safety. The journal aims to publish the highest quality research articles, reviews and case reports in the field. Topics covered include: adverse effects of individual drugs and drug classes, management of adverse effects, pharmacovigilance and pharmacoepidemiology of new and existing drugs, post-marketing surveillance. The journal is essential reading for all researchers and clinicians involved in drug safety.
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