Conclusion:
This case fits the clinical presentation of DRESS syndrome and occurred
during drug therapy with allopurinol, a known causative agent. The onset
of symptoms occurring 22 months after drug initiation has not previously
been reported in the literature. Thus, a prolonged delay between the
start of treatment and the appearance of a febrile rash should never
exclude the diagnosis of Dress syndrome or delay its management.
References:
1. Choudhary S, McLEOD M, Torchia D, Romanelli P. Drug Reaction with
Eosinophilia and Systemic Symptoms (DRESS) Syndrome. 2013;6.
2. Tohyama M, Hashimoto K, Yasukawa M, Kimura H, Horikawa T, Nakajima K,
et al. Association of human herpesvirus 6 reactivation with the flaring
and severity of drug-induced hypersensitivity syndrome. Br J Dermatol.
2007;157:934‑40.
3. Sasidharanpillai S, Ajithkumar K, Jishna P, Khader A, Anagha K,
Binitha M, et al. RegiSCAR DRESS (drug reaction with eosinophilia and
systemic symptoms) validation scoring system and Japanese consensus
group criteria for atypical drug-induced hypersensitivity syndrome
(DiHS): A comparative analysis. Indian Dermatol Online J. 2022;13:40.
4. Miremont-Salamé G, Théophile H, Haramburu F, Bégaud B. Causality
assessment in pharmacovigilance: The French method and its successive
updates. Therapies. 2016;71:179‑86.
5. Montastruc JL. Pharmacovigilance and drug safety: Fair prescribing
and clinical research. Therapies. 2022;77:261‑3.
6. Myers CM, Miller JJ, Davis WD. Allopurinol-Induced Drug Reaction With
Eosinophilia and Systemic Symptoms: A Case Report. Adv Emerg Nurs J.
2020;42:108‑18.
7. Koike M, Kanno Y, Tomori K, Okada H, Suzuki H. Viruses may trigger
allopurinol hypersensitivity syndrome. Clin Kidney J. 2008;1:273‑4.
8. Descamps V, Ranger-Rogez S, Musette P, Barbaud A. Le DRESS (drug
reaction with eosinophilia and systemic symptoms): une synergie
médicaments-virus qui peut conduire en réanimation. Réanimation.
2011;20:223‑7.
9. Hewitt N, Levinson M, Stephenson G. Drug reaction with eosinophilia
and systemic symptoms associated with H1N1 vaccination. Intern Med J.
2012;42:1365‑6.