Severe DRESS syndrome after carbamazepine intake in a case with multiple addictions: A case report

Vrinceanu,Daniela; Dumitru,Mihai; Stefan,Adrian; Neagos,Adriana; Musat,Gabriela; Nica,Elena   Adriana

doi:10.3892/etm.2020.8894

Severe DRESS syndrome after carbamazepine intake in a case with multiple addictions: A case report

Authors:
- Daniela Vrinceanu
- Mihai Dumitru
- Adrian Stefan
- Adriana Neagos
- Gabriela Musat
- Elena Adriana Nica
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Affiliations: ENT Department, Bucharest Emergency University Hospital, 010271 Bucharest, Romania, Department of Anatomy, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, ENT Department, Târgu Mureș University of Medicine and Pharmacy, 540139 Târgu Mureș, Romania, ENT Department, ‘Sânta Maria’ Clinical Hospital, 011172 Bucharest, Romania, Department of Anesthesia and ICU, Bucharest Emergency University Hospital, 020021 Bucharest, Romania
Published online on: June 17, 2020 https://doi.org/10.3892/etm.2020.8894
Pages: 2377-2380

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Abstract

A case is presented of a male with drug rash with eosinophilia and systemic symptoms (DRESS) syndrome induced by carbamazepine intake. The patient presented all the elements of DRESS syndrome: Skin reaction, fever, enlargement of the lymph nodes, increased eosinophils and lymphocytes, with associated organ dysfunctions. The patient was admitted with acute laryngeal edema and imminence of respiratory insufficiency. The escalation of symptoms for this syndrome is typical, even after the administering of the the culprit medicine has ceased. However, in this case, the most difficult aspect was the complex treatment scheme prior to admission. All medical compounds involved in the background treatment were substituted with other substances in order to control the immune response. Current knowledge regarding DRESS is reviewed and possible influence of various etiologies over the present case are discussed. Clinicians should be aware of this rare situation with life-threatening potential. We benefited from the advantage of reuniting the knowledge of a complex team of experts from various tertiary emergency units in Romania.

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