Sulfasalazine-induced DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms)

Sao Paulo Med J. 2008 Jul;126(4):225-6. doi: 10.1590/s1516-31802008000400006.

Abstract

Context: DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is a type of drug reaction commonly mistaken for a viral infection. It must be recognized promptly due to its high morbidity and 10% mortality rate. Few cases of DRESS syndrome induced by sulfasalazine have been reported in the literature.

Case report: The case of a 47-year-old white Brazilian woman who developed DRESS syndrome eight weeks after starting a course of sulfasalazine for treatment of seronegative arthritis is reported. She presented a skin rash, fever, hepatitis, lymphadenopathy, eosinophilia and atypical lymphocytes. The causative drug was discontinued immediately, but she only improved after treatment with prednisone.

CONTEXTO:: A síndrome DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) é um tipo de reação a drogas comumente confundida com uma infecção viral. Deve ser prontamente reconhecida devido a sua alta morbidade e taxa de mortalidade de 10%. Poucos casos de síndrome DRESS induzida por sulfasalazina foram relatados na literatura.

RELATO DE CASO:: É relatado o caso de uma mulher branca, brasileira, de 47 anos, que desenvolveu a síndrome DRESS oito semanas após iniciar tratamento com sulfasalazina para artrite soronegativa. A paciente apresentou rash maculopapular, febre, hepatite, linfadenomegalia, eosinofilia e linfocitose atípica. A medicação foi suspensa imediatamente no início dos sintomas, mas só houve melhora clínica após tratamento com prednisona.

Publication types

  • Case Reports

MeSH terms

  • Antirheumatic Agents / adverse effects*
  • Arthritis / drug therapy
  • Drug Eruptions / diagnosis
  • Drug Eruptions / etiology*
  • Eosinophilia / chemically induced*
  • Eosinophilia / diagnosis
  • Female
  • Humans
  • Middle Aged
  • Sulfasalazine / adverse effects*
  • Syndrome

Substances

  • Antirheumatic Agents
  • Sulfasalazine