Drug reaction with eosinophilia and systemic symptoms syndrome to non-steroidal anti-inflammatory drugs: A report of case series and literature review

IF 0.3 4区医学

Revue Francaise d Allergologie Pub Date : 2025-03-20 DOI:10.1016/j.reval.2024.104221

M. Daldoul , O. Charfi , F. Zgolli , K. Ferchichi , G. Lakhoua , S. Kastalli , R. Daghfous , A. Zaiem , I. Aouinti , S. El Aidli

{"title":"Drug reaction with eosinophilia and systemic symptoms syndrome to non-steroidal anti-inflammatory drugs: A report of case series and literature review","authors":"M. Daldoul , O. Charfi , F. Zgolli , K. Ferchichi , G. Lakhoua , S. Kastalli , R. Daghfous , A. Zaiem , I. Aouinti , S. El Aidli","doi":"10.1016/j.reval.2024.104221","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>DRESS syndrome is a rare, severe cutaneous adverse reaction that has been exceptionally described with NSAIDs. The objective of our study was to investigate the clinical, paraclinical, and epidemiological characteristics of DRESS syndrome associated with NSAIDs and to identify the implicated molecules.</div></div><div><h3>Patients and methods</h3><div>A retrospective descriptive study that included all cases of DRESS syndrome occurring with NSAIDs and reported over a 10-year period. Records were analyzed according to the RegiSCAR criteria for the diagnosis of DRESS and the French imputability method.</div></div><div><h3>Results</h3><div>We included 7 cases, with a female-to-male ratio of 1.33. The age of patients ranged from 18 to 75 years, with a mean of 55 years. The time to onset varied from 4 to 30 days, with a mean of 12 days. A fever equal to or greater than 38.5°C was observed in 5 patients. All patients had skin involvement, mainly in the form of a maculopapular rash in 6 cases and erythroderma with glossitis in one case. Hypereosinophilia was found in 4 out of 7 patients. Hepatic involvement was observed in 4 patients, associated with renal involvement in 2 cases. One patient had isolated renal involvement. The NSAIDs implicated in DRESS syndrome in our patients were diclofenac, piroxicam, ketoprofen, and celecoxib.</div></div><div><h3>Conclusion</h3><div>Our study highlights the rarity and potential severity of DRESS syndrome associated with NSAIDs, due to systemic involvement. Clinicians should be vigilant about the possibility of DRESS syndrome with NSAID use, in order to promptly discontinue the implicated drug and ensure rapid management.</div></div>","PeriodicalId":49130,"journal":{"name":"Revue Francaise d Allergologie","volume":"65 4","pages":"Article 104221"},"PeriodicalIF":0.3000,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revue Francaise d Allergologie","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1877032024004421","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

DRESS syndrome is a rare, severe cutaneous adverse reaction that has been exceptionally described with NSAIDs. The objective of our study was to investigate the clinical, paraclinical, and epidemiological characteristics of DRESS syndrome associated with NSAIDs and to identify the implicated molecules.

Patients and methods

A retrospective descriptive study that included all cases of DRESS syndrome occurring with NSAIDs and reported over a 10-year period. Records were analyzed according to the RegiSCAR criteria for the diagnosis of DRESS and the French imputability method.

Results

We included 7 cases, with a female-to-male ratio of 1.33. The age of patients ranged from 18 to 75 years, with a mean of 55 years. The time to onset varied from 4 to 30 days, with a mean of 12 days. A fever equal to or greater than 38.5 °C was observed in 5 patients. All patients had skin involvement, mainly in the form of a maculopapular rash in 6 cases and erythroderma with glossitis in one case. Hypereosinophilia was found in 4 out of 7 patients. Hepatic involvement was observed in 4 patients, associated with renal involvement in 2 cases. One patient had isolated renal involvement. The NSAIDs implicated in DRESS syndrome in our patients were diclofenac, piroxicam, ketoprofen, and celecoxib.

Conclusion

Our study highlights the rarity and potential severity of DRESS syndrome associated with NSAIDs, due to systemic involvement. Clinicians should be vigilant about the possibility of DRESS syndrome with NSAID use, in order to promptly discontinue the implicated drug and ensure rapid management.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Revue Francaise d Allergologie Medicine-Immunology and Allergy

自引率

33.30%

发文量

349

期刊介绍： La Revue Française d''Allergologie : un véritable forum pour faire connaître des travaux originaux et permettre la diffusion de l''information auprès de toutes les spécialités concernées par les pathologies allergiques. La Revue Française d''Allergologie (8 numéros par an) est au carrefour de nombreuses spécialités - dermatologie, pédiatrie, ORL, pneumologie, ophtalmologie, médecine interne - qui, toutes, ont à traiter des maladies allergiques. Les symptômes des allergies fondés sur des mécanismes communs sont le plus souvent associés et se succèdent chez un même patient. En forte progression depuis 20 ans, les maladies allergiques sont dans l''attente de perfectionnements et d''avancées thérapeutiques qui permettront aux nombreux patients qui en sont atteints de mieux vivre avec leurs allergies. La Revue Française d''Allergologie se veut donc un véritable forum de discussions et d''échanges entre tous les spécialistes confrontés aux pathologies