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[Venous thrombosis, unrecognized complication of DRESS]
F Medhioub Kaaniche1, R Allela1, N Ben Algia2
1Département de soins intensifs, hôpital régional Mahres, route Bohtari, 3060 Sfax, Tunisie.
Annales De Dermatologie Et De Venereologie
|August 16, 2016
Summary
Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a severe condition. This case highlights a rare venous thrombosis complication in DRESS, potentially linked to hypereosinophilia, suggesting anticoagulant prophylaxis.
Area of Science:
- Immunology
- Dermatology
- Hematology
Background:
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a rare, potentially fatal drug hypersensitivity.
- Characterized by delayed onset of symptoms and severe organ involvement.
- Allopurinol is a common trigger, necessitating vigilance in clinical practice.
Observation:
- A 42-year-old female presented with DRESS symptoms one month post-allopurinol initiation.
- Clinical presentation included febrile exanthema, facial edema, polyadenopathy, and significant hypereosinophilia.
- Diagnosis of DRESS was confirmed with a RegiSCAR score of 5, alongside positive HHV-6 IgM serology.
Findings:
- The patient developed internal jugular vein thrombosis two days after initiating systemic corticosteroids.
- Major hypereosinophilia was identified as a potential contributing factor to thrombosis.
- Treatment with anticoagulants and corticosteroids led to a favorable outcome.
Implications:
- Venous thrombosis is a rare but serious complication of DRESS.
- Hypereosinophilia may play a role in the pathogenesis of DRESS-associated thrombosis.
- Prophylactic anticoagulation should be considered in DRESS patients with significant hypereosinophilia.
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