Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome induced by celecoxib and anti-tuberculosis drugs.
Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome reflects a serious hypersensitivity reaction to drugs, characterized by skin rash, fever, lymph node enlargement, and internal organ involvement. So far, numerous drugs such as sulfonamides, phenobarbital, sulfasalazine, carbamazepine, and phenytoin have been reported to cause the DRESS syndrome. We report a case in a 29-yr-old female patient who had been on celecoxib and anti-tuberculosis drugs for one month to treat knee joint pain and pulmonary tuberculosis. Our patient's clinical manifestations included fever, lymphadenopathy, rash, hypereosinophilia, and visceral involvement (hepatitis and pneumonitis). During the corticosteroid administration for DRESS syndrome, swallowing difficulty with profound muscle weakness had developed. Our patient was diagnosed as DRESS syndrome with eosinophilic polymyositis by a histopathologic study. After complete resolution of all symptoms, patch tests were positive for both celecoxib and ethambutol. Although further investigations might be needed to confirm the causality, celecoxib and ethambutol can be added to the list of drugs as having the possibility of DRESS syndrome.
Lee
Joo Ho
JH
Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea.
Park
Hye-Kyung
HK
Heo
Jeong
J
Kim
Tae Oh
TO
Kim
Gwang Ha
GH
Kang
Dae Hwan
DH
Song
Geun Am
GA
Cho
Mong
M
Kim
Dae Sung
DS
Kim
Hwal Woong
HW
Lee
Chang Hun
CH
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000995:Antitubercular Agents / Q000009:adverse effects; D001168:Arthritis / Q000150:complications / Q000188:drug therapy*; D000068579:Celecoxib; D003875:Drug Eruptions / Q000209:etiology* / Q000473:pathology; D004802:Eosinophilia / Q000139:chemically induced* / Q000473:pathology; D004977:Ethambutol / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009220:Myositis / Q000139:chemically induced / Q000473:pathology; D011720:Pyrazoles / Q000009:adverse effects*; D013449:Sulfonamides / Q000009:adverse effects*; D013577:Syndrome; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000188:drug therapy*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000995:Antitubercular Agents; D011720:Pyrazoles; D013449:Sulfonamides; D004977:Ethambutol; D000068579:Celecoxib