[DRESS syndrome to allopurinol: a case in Dakar].
We report a case of DRESS syndrome also called drug hypersensitivity reaction occurring a 47 years old Senegalese man who has been taking allopurinol for 3 months. That drug was prescribed for peripheric arthralgias associated to a hyperuricemia. He presented a generalised pruritus, cutaneous lesions, fever and facial oedema. On the biological examens, hyperleucocytosis with hypereosinophilia and hyperlymphocytosis associated to the presence of segmented basophiles. In addition, a hepatic cytolysis and cholestasis were documented. Liver ultrasound was normal. The hemocults were negative. These following serologies have been performed and were negative: hepatitis B and C, Epstein Barr-virus, cytomegalovirus, syphilis, toxoplasma and parvovirus B19. The anti-nuclear and anti-DNA antibodies were negative. A favourable clinical evolution was remarked after allopurinol treatment withdrawal. A desquamation occurred after 6 days and hemogram turned out to the normal as well as the hepatic tests after 2 weeks. The virologic examens performed 2 months later were unremarkable. This case point out the importance of the early diagnosis and quick withdrawal of the drug in order to prevent serious forms leading to the 10% of death.
Dia
D
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Service de Médecine interne, Hôpital Aristide Le Dantec, Dakar.
Ba-Fall
K
K
Bouldouyre
M
M
Chevalier
B
B
Debonne
J M
JM
D000493:Allopurinol / Q000009:adverse effects* / Q000627:therapeutic use; D000963:Antimetabolites / Q000009:adverse effects* / Q000627:therapeutic use; D018771:Arthralgia / Q000188:drug therapy; D003875:Drug Eruptions; D004487:Edema / Q000139:chemically induced; D005334:Fever / Q000139:chemically induced; D006801:Humans; D033461:Hyperuricemia / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012675:Senegal; D013577:Syndrome
D000963:Antimetabolites; D000493:Allopurinol