Methyldopa hypersensitivity syndrome

A 74-year-old man developed an extensive erythematous skin eruption, fever, lymphadenopathy and eosinophilia probably due to methyldopa. The symptoms reappeared shortly after unintentional reexposure to the drug. The positive results of two in vitro tests for the detection of drug allergy not only give further support to the causal relationship between the drug and the symptoms, but also indicate the involvement of an immunologic, allergic mechanism. Although every individual symptom represented in our case has been reported in previous cases, the association of the symptoms together in one patient has never before been reported. An awareness that adverse reactions to methyldopa can mimic a variety of acute infectious diseases and lymphoproliferative disorders is the key to diagnosis and might prevent unnecessary hospitalizations, procedures, and use of potentially toxic antibiotics and chemotherapy.