title: Cyclophosphamide therapy for corticoresistant drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome in a patient with severe kidney and eye involvement and Epstein-Barr virus reactivation.
abstract: DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome is a severe adverse drug reaction with significant mortality, characterized by erythroderma, fever, lymphadenopathy, and visceral involvement. We report a case of multivisceral DRESS syndrome with posterior multifocal placoid pigment epitheliopathy and acute tubulointerstitial nephritis responsible for dialysis-dependent acute kidney failure in the context of reactivation of Epstein-Barr virus infection. Because of resistance of the skin and kidney manifestations to prolonged corticosteroid therapy, a 6-month course of oral cyclophosphamide resulted in complete recovery of all symptoms. To our knowledge, this is the first case showing the efficacy of cyclophosphamide in severe DRESS syndrome.
authors.affiliation: Department of Dermatology, CHU Poitiers, Poitiers, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Laban
authors.forename: Eva
authors.initials: E
authors.lastname: Hainaut-Wierzbicka
authors.forename: François
authors.initials: F
authors.lastname: Pourreau
authors.forename: Mokrane
authors.initials: M
authors.lastname: Yacoub
authors.forename: Emilie
authors.initials: E
authors.lastname: Sztermer
authors.forename: Gérard
authors.initials: G
authors.lastname: Guillet
authors.forename: Guy
authors.initials: G
authors.lastname: Touchard
authors.forename: Frank
authors.initials: F
authors.lastname: Bridoux
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000188:drug therapy*; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use*; D004351:Drug Resistance; D064420:Drug-Related Side Effects and Adverse Reactions / Q000188:drug therapy* / Q000209:etiology; D004802:Eosinophilia / Q000139:chemically induced / Q000188:drug therapy*; D020031:Epstein-Barr Virus Infections / Q000139:chemically induced*; D005128:Eye Diseases / Q000139:chemically induced / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide