DRESS syndrome induced by imatinib.
1Department of Dermatology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Journal of Postgraduate Medicine
|August 24, 2021
Summary
Drug rash with eosinophilia and systemic symptoms (DRESS) is a severe reaction. This case highlights DRESS from imatinib in chronic myeloid leukemia (CML) and successful management with dasatinib.
Area of Science:
- Pharmacology
- Dermatology
- Hematology
Background:
- Drug rash with eosinophilia and systemic symptoms (DRESS) is a severe hypersensitivity reaction.
- It necessitates drug withdrawal and replacement therapy.
- Chronic myeloid leukemia (CML) treatment often involves tyrosine kinase inhibitors.
Observation:
- A 55-year-old male with CML developed DRESS after 3 weeks of imatinib therapy.
- Symptoms included fever, rash, facial edema, eosinophilia, and elevated liver enzymes.
- Diagnosis was confirmed by clinical findings, eosinophilia, skin biopsy, and RegiSCAR score.
Findings:
- Imatinib was discontinued, and the patient received low-dose steroids, leading to symptom resolution.
- Positive imatinib rechallenge confirmed the drug as the cause.
- The patient was switched to dasatinib, achieving an optimal molecular response.
Implications:
- DRESS secondary to imatinib is rare, with only eight prior reports.
- This case underscores the importance of recognizing and managing DRESS in CML patients.
- Effective management of DRESS can allow for continued CML treatment with alternative agents.
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