A case of sulphasalazine-induced DRESS syndrome with delayed acute interstitial nephritis.
Drug rash with eosinophilia and systemic symptoms (DRESS syndrome) is a rare and severe drug-induced hypersensitivity syndrome characterized by haematological abnormalities (hypereosinophilia and/or mononucleosis) and multiorgan involvement. Renal failure has been rarely described. We report the case of a 77-year-old female with sulphasalazine-induced DRESS syndrome who improved rapidly on corticosteroid treatment. After prednisone withdrawal, the patient developed renal failure that necessitated a session of haemodialysis. A kidney biopsy showed acute tubulointerstitial nephritis with an intense lymphocytic infiltrate and tubular necrosis. Kidney function normalized after a further 2 weeks of corticosteroid treatment. This is the first histologically proven case of acute tubulointerstitial nephritis in the setting of sulphasalazine-induced DRESS syndrome.
Augusto
Jean-François
JF
University of Angers, France. jfaugusto@chu-angers.fr
Sayegh
Johnny
J
Simon
Amélie
A
Croue
Anne
A
Chennebault
Jean-Marie
JM
Cousin
Maud
M
Subra
Jean-François
JF
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003875:Drug Eruptions / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D004802:Eosinophilia / Q000139:chemically induced* / Q000188:drug therapy; D005260:Female; D015654:Herpesvirus 6, Human; D006801:Humans; D009395:Nephritis, Interstitial / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use; D019349:Roseolovirus Infections / Q000150:complications; D012460:Sulfasalazine / Q000009:adverse effects*; D013577:Syndrome; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D012460:Sulfasalazine; D011241:Prednisone