Dress syndrome with significant gastrointestinal involvement : a case report with review of literature

Abstract EN

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially lifethreatening adverse drug-induced reaction, with an estimated mortality of 10%.

Diagnosing DRESS syndrome is challenging due to the diversity of cutaneous eruption and organs involved.

I describe a 39 year-old lady who presented with fever and rash a month after starting sulfasalazine.

Investigations revealed leukocytosis, eosinophilia and elevated serum transaminases.

The diagnosis of DREES syndrome was made, sulfasalazine was stopped and systemic steroid given.

Symptoms began to resolve within 2 days of steroid therapy.

I reviewed 40 cases of sulfasalazine induced DRESS syndrome reported in the literature and applied 3 scoring systems that define and grade these cases of DRESS syndrome.

In the reviewed cases elevated transaminases and eosinophilia were the most constant findings (94.9% and 84.2% respectively), 4 cases (10%) died from acute liver and heart failure as a complication of DRESS syndrome.