Severe enterocolitis associated with antiepileptic-induced drug reaction with eosinophilia and systemic symptoms

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare but serious drug-induced reaction with cutaneous, hematologic, and solid-organ injury. Antiepileptic drugs are one of the most common classes of drugs implicated in DRESS. A high morbidity and mortality may result, especially if the offending drug is not withdrawn promptly. Although DRESS may involve many organs, severe involvement of the gastrointestinal tract in DRESS and/or in association with antiepileptic drugs has rarely been reported. We report detailed clinical and histopathologic findings of a fatal case of DRESS syndrome resulting from antiepileptic drug treatment that was accompanied by severe enterocolitis, malabsorption, and cachexia.