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Case Report Open Access

Drug-induced Rowell syndrome, a rare and difficult to manage disease: A case report

  • Authors:
    • Daciana Elena Brănișteanu
    • Simona Laura Ianoşi
    • Andreea Dimitriu
    • Gabriela Stoleriu
    • Alexandru Oanţǎ
    • Daniel Constantin Brănișteanu
  • View Affiliations / Copyright

    Affiliations: Department of Dermatology, Grigore T. Popa University of Medicine and Pharmacy, 700715 Iași, Romania, Department of Dermatology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania, Department of Dermatology, Transilvania University of Brașov, 500036 Brasov, Romania, Department of Ophthalmology, Grigore T. Popa University of Medicine and Pharmacy, 700715 Iași, Romania
    Copyright: © Brănișteanu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 785-788
    |
    Published online on: November 23, 2017
       https://doi.org/10.3892/etm.2017.5557
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Abstract

Rowell syndrome is defined as the association between lupus erythematosus, erythema multiforme‑like lesions and characteristic immunological changes including positive tests for rheumatoid factor, speckled antinuclear antibody, positive anti‑Ro or anti‑La antibodies. The present report presents the case of a 45‑year‑old female patient who was previously diagnosed in January 2010 with terbinafine‑induced subacute cutaneous lupus erythematosus and was admitted for a skin eruption consisting of erythematous‑papular erythema multiforme‑like lesions, primarily on the trunk and limbs. The associated symptoms consisted of fatigability, myalgia and gonalgia. In October 2015, the illness reoccurred ~1 week after the initiation of Helicobacter pylori eradication treatment. Anti‑Ro antibodies, rheumatoid factor and antinuclear antibody tests were positive. Given the patient's medical history, clinical manifestations, and laboratory, histopathological and immunofluorescence microscopy findings, a diagnosis of Rowell syndrome was made. Systemic corticosteroids (methylprednisolone; 0.5 mg/kg/day) and immunomodulatory therapy (azathioprine; 50 mg/day) were administered with the associated medication (omeprazole, 20 mg/day; KCl, 1 g/day) and topical dermocorticoids (fluticasone propionate 0.05% cream; 1 application/day), with a favorable outcome. The major diagnostic criteria for Rowell syndrome are the presence of lupus erythematosus (acute, subacute or systemic), erythema multiforme‑like lesions and positive testing for antinuclear antibodies. The minor diagnostic criteria for Rowell syndrome are chilblains, the presence of anti‑Ro antibodies and positive testing for rheumatoid factor. A diagnosis of Rowell syndrome is made if the patient exhibits all major criteria and at least one minor criterion. The present case met all diagnostic criteria, excluding the presence of chilblains. Notably, in this case there was a co‑occurrence of subacute lupus erythematosus and Rowell syndrome lesions, which was drug-induced.
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Copy and paste a formatted citation
Spandidos Publications style
Brănișteanu DE, Ianoşi SL, Dimitriu A, Stoleriu G, Oanţǎ A and Brănișteanu DC: Drug-induced Rowell syndrome, a rare and difficult to manage disease: A case report. Exp Ther Med 15: 785-788, 2018.
APA
Brănișteanu, D.E., Ianoşi, S.L., Dimitriu, A., Stoleriu, G., Oanţǎ, A., & Brănișteanu, D.C. (2018). Drug-induced Rowell syndrome, a rare and difficult to manage disease: A case report. Experimental and Therapeutic Medicine, 15, 785-788. https://doi.org/10.3892/etm.2017.5557
MLA
Brănișteanu, D. E., Ianoşi, S. L., Dimitriu, A., Stoleriu, G., Oanţǎ, A., Brănișteanu, D. C."Drug-induced Rowell syndrome, a rare and difficult to manage disease: A case report". Experimental and Therapeutic Medicine 15.1 (2018): 785-788.
Chicago
Brănișteanu, D. E., Ianoşi, S. L., Dimitriu, A., Stoleriu, G., Oanţǎ, A., Brănișteanu, D. C."Drug-induced Rowell syndrome, a rare and difficult to manage disease: A case report". Experimental and Therapeutic Medicine 15, no. 1 (2018): 785-788. https://doi.org/10.3892/etm.2017.5557
Copy and paste a formatted citation
x
Spandidos Publications style
Brănișteanu DE, Ianoşi SL, Dimitriu A, Stoleriu G, Oanţǎ A and Brănișteanu DC: Drug-induced Rowell syndrome, a rare and difficult to manage disease: A case report. Exp Ther Med 15: 785-788, 2018.
APA
Brănișteanu, D.E., Ianoşi, S.L., Dimitriu, A., Stoleriu, G., Oanţǎ, A., & Brănișteanu, D.C. (2018). Drug-induced Rowell syndrome, a rare and difficult to manage disease: A case report. Experimental and Therapeutic Medicine, 15, 785-788. https://doi.org/10.3892/etm.2017.5557
MLA
Brănișteanu, D. E., Ianoşi, S. L., Dimitriu, A., Stoleriu, G., Oanţǎ, A., Brănișteanu, D. C."Drug-induced Rowell syndrome, a rare and difficult to manage disease: A case report". Experimental and Therapeutic Medicine 15.1 (2018): 785-788.
Chicago
Brănișteanu, D. E., Ianoşi, S. L., Dimitriu, A., Stoleriu, G., Oanţǎ, A., Brănișteanu, D. C."Drug-induced Rowell syndrome, a rare and difficult to manage disease: A case report". Experimental and Therapeutic Medicine 15, no. 1 (2018): 785-788. https://doi.org/10.3892/etm.2017.5557
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