Leflunomide-induced DRESS syndrome with renal involvement and vasculitis

Clin Rheumatol. 2013 May;32(5):689-93. doi: 10.1007/s10067-012-2152-8. Epub 2012 Dec 28.


DRESS or drug reaction (or rash) with eosinophilia and systemic symptoms belongs to the severe cutaneous adverse reaction group and is characterized by hematological abnormalities and visceral organ involvement. Although most often related with anticonvulsant and sulfonamide use, it is reported with numerous other drugs. We report an unusual case of DRESS syndrome due to Leflunomide, also complicated by renal involvement in the form of granulomatous interstitial nephritis and vasculitis. On a review of the literature, eight similar cases were found, and these are discussed.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antirheumatic Agents / adverse effects
  • Biopsy
  • Drug Hypersensitivity Syndrome / etiology*
  • Eosinophilia / metabolism
  • Erythema / etiology
  • Exanthema / complications
  • Exanthema / drug therapy
  • Humans
  • Isoxazoles / adverse effects*
  • Kidney Diseases / chemically induced*
  • Leflunomide
  • Male
  • Middle Aged
  • Nephritis / complications
  • Time Factors
  • Treatment Outcome
  • Vascular Diseases / chemically induced*


  • Antirheumatic Agents
  • Isoxazoles
  • Leflunomide