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D
rug
reaction
with
eosinophilia
and
systemic
symptoms
(DRESS
syndrome
)
R
ev
A
ssoc
M
ed
B
ras
2016; 62(3):227-230
227
ORIGINAL ARTICLE
Drug reaction with eosinophilia and systemic symptoms (DRESS
syndrome)
S
oraia
A
parecida
da
S
ilva
¹
, M
ariana
M
aciel
P
ereira
de
F
igueiredo
²
*, L
auro
C
arneiro
N
eto
³
, D
ébora
B
orowiak
R
eiss
4
,
M
ariana
A
maranto
de
S
ouza
D
amásio
4
1
MD, Specialist degree in Internal Medicine from Sociedade Brasileira de Clínica Médica. Manager of Adult and Senior Care and Hospital Internship Preceptor at Hospital Municipal Odilon Behrens (HOB).
Professor, Faculdade da Saúde e Ecologia Humana (Faseh), Belo Horizonte, MG, Brazil
2
Medical Student – Faculdade de Medicina de Barbacena, Fundação José Bonifácio Lafayette de Andrada (Fame/Funjob), Hospital Internship – 12
th
semester, Barbacena, MG, Brazil
3
Dental Surgeon – Medical Student, Fame/Funjob, Hospital Internship – 12
th
semester, Barbacena, MG, Brazil
4
Medical Student – Faseh, Hospital Internship, 11
th
semester, Vespasiano, MG, Brazil
S
ummary
Study conducted at Hospital Municipal
Odilon Behrens, Belo Horizonte,
MG, Brazil
Article received:
9/1/2014
Accepted for publication:
9/16/2014
*Correspondence:
Address: Rua Formiga, 50,
Bairro São Cristóvão
Belo Horizonte, MG – Brazil
Postal code: 31210-780
marianamaciel_9@hotmail.com http://dx.doi.org/10.1590/1806-9282.62.03.227Objective:
To review the hypersensitivity reaction to drugs known as drug reac-
tion with eosinophilia and systemic symptoms (DRESS syndrome), based on a
case report. We also intend to discuss the difficulty and importance of disease
recognition, since none of the changes is pathognomonic of this disease and fail-
ure to identify it may have disastrous consequences for the patient.
Method:
To describe this case report, in addition to the information collected
for clinical assessment, a literature review was performed in the PubMed and Bi-
reme databases in order to retrieve the latest information published in literature
on DRESS syndrome.
Results:
The case of a 20-year old patient is reported. After anamnesis, physical
examination and laboratory tests a diagnosis of DRESS syndrome was performed,
characterized by rash, hematologic alterations, lymphadenopathy and lesions
in target organ. This is a rare syndrome, whose frequency varies according to the
drug used and the immune status of the patient, being more often associated
with the use of anticonvulsants.
Conclusion:
The approach and discussion of the topic are of paramount im-
portance, in view of the potential lethality of this treatable syndrome. Recogniz-
ing the occurrence of DRESS syndrome and starting treatment as soon as pos-
sible is crucial to reduce the risk of mortality and improve prognosis.
Keywords:
eosinophilia, drug eruptions, adult, drug hypersensitivity.
O
bjective
To conduct a review on the drug hypersensitivity reaction
called drug reaction with eosinophilia and systemic symp-
toms (DRESS syndrome), based on a case report.
To examine the latest information published in the
national and international literature on DRESS syn-
drome, listing the main drugs involved, disease patho-
genesis, diagnostic criteria, differential diagnosis, and
treatment.
To discuss the difficulty and importance of recogni-
tion, since none of the changes are pathognomonic of
the disease, and failure to identify it can lead to disas-
trous consequences for the patient.
M
ethod
Bibliographical research in national and international
databases, including case reports and review articles, writ-
ten in English and Portuguese.
The survey was conducted between May and July 2014
on the websites of Bireme/PAHO/WHO – Latin American
and Caribbean Center on Health Sciences Information,
and the PubMed. Keywords used included: “Eosinophilia”,
“drug eruption”, “adult” and “drug hypersensitivity”.
R
esults
Characterized by rash, fever, hematological abnormali-
ties (eosinophilia and atypical lymphocytosis), lymphade-