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Publicação
Acute Hepatitis in the DRESS Syndrome
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Autores
Orientador(es)
Resumo(s)
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a
severe, idiosyncratic reaction characterized by diffuse maculopapular rash, facial edema, lym-
phadenopathy, fever, eosinophilia and/or other leukocyte abnormalities, and involvement of
internal organs as liver, kidney, heart and lung.
Diagnosing this entity is specifically complicated due to the multiplicity of organs involved.
DRESS syndrome must be recognized promptly and the causative drug withdrawn in order to
improve patient outcomes. Indeed, it is a potentially life-threatening condition, with a reported
mortality between 5 and 20%.
We describe a case of a 22-year old woman admitted to our hospital with acute diffuse,
pruritic rash associated with crampy abdominal pain, vomiting, diarrhea and fever three weeks
after starting sulfasalazine therapy.
Initially, laboratory parameters revealed normal white blood cell count and normal liver
enzymes, but during hospitalization, eosinophilia developed and liver enzymes, including
transaminases and cholestatic parameters, dramatically increased. The diagnostic of DRESS syn-
drome was made and sulfasalazine was withdrawn and as there were signs of disease severity,
systemic corticotherapy was initiated, with gradually improvement of the rash and symptoms
resolution.
The patient was discharged home after thirty days of hospitalization.
Descrição
Palavras-chave
Hepatitis Chemical and drug induced liver injury
Contexto Educativo
Citação
GE Port J Gastroenterol. 2016;23(6):304-308
Editora
Sociedade Portuguesa de Gastrenterologia