[DRESS syndrome with bilateral panuveitis, elevated intraocular pressure, and HHV-6 reactivation: a case report].
BACKGROUND
DRESS syndrome (drug rash or reaction with eosinophilia and systemic symptoms) is a rare but life-threatening drug hypersensitivity syndrome with a potential viral cofactor. The syndrome is characterized by rash, fever, hematological disorders (eosinophilia, lymphocytosis), and systemic symptoms (adenopathy, multiorgan involvement).


METHODS
We report the first description of acute bilateral panuveitis with elevated intraocular pressure associated with anticonvulsant-induced DRESS syndrome, hypogammaglobulinemia, and HHV-6 reactivation in a 63-year-old-woman. Complete general and ophthalmological recovery was obtained 4 weeks after the end of anticonvulsant drug exposure without corticosteroid prescription, with the patient remaining free of disease after 6 months.


CONCLUSIONS
Our data suggest that uveitis may be one of multivisceral involvements described in drug hypersensitivity syndrome. The data also suggest that HHV-6 may play a role in the complex pathogenesis of DRESS as well as in the development of immune inflammatory disorders such as bilateral panuveitis with elevated intraocular pressure and alteration of retinal and choroidal circulation in this patient.
Schauer
P
P
Service d'Ophtalmologie, Hôpital d'instruction des Armées Robert Picqué, Bordeaux. schauerphilippe@yahoo.fr
Salaun
N
N
Bazin
S
S
Labrouze
J-M
JM
Bourguignon
G
G
D004802:Eosinophilia / Q000150:complications*; D005076:Exanthema / Q000150:complications*; D005260:Female; D015654:Herpesvirus 6, Human / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D009798:Ocular Hypertension / Q000150:complications*; D015864:Panuveitis / Q000150:complications*; D019349:Roseolovirus Infections / Q000150:complications*; D013577:Syndrome