title: Drug rash with eosinophilia and systemic symptoms secondary to sulfasalazine.
abstract: A severe cutaneous eruption in an unwell patient can be a major cause of physician anxiety. With numerous differential diagnoses, an early accurate diagnosis can be challenging. infectious causes are the most important to exclude in a timely manner and drug rash and eosinophilia with systemic symptoms (DRESS) is another differential diagnosis that should be considered in children. This hypersensitivity reaction is associated with multisystem involvement. Children with underlying chronic diseases may have impairment of normal metabolic pathways and are also often on multiple medications. Therefore, drugs should always be considered in the aetiopathology of any new symptoms and signs. This case report informs readers of the association of sulfasalazine and DRESS in an 11-year-old with inflammatory bowel disease and discusses its pathogenesis and treatment. Increased awareness of this disorder will hopefully lead to increased reporting and consequently illuminate the syndrome more clearly and help guide its prevention and treatment.
authors.affiliation: Department of Gastroenterology, The Royal Children's Hospital, Melbourne, Victoria, Australia. jeremy@rosenbaum.net
authors.forename: Jeremy
authors.initials: J
authors.lastname: Rosenbaum
authors.forename: George
authors.initials: G
authors.lastname: Alex
authors.forename: Hugh
authors.initials: H
authors.lastname: Roberts
authors.forename: David
authors.initials: D
authors.lastname: Orchard
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D015209:Cholangitis, Sclerosing / Q000139:chemically induced; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D003937:Diagnosis, Differential; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology*; D004802:Eosinophilia / Q000139:chemically induced*; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D006801:Humans; D012460:Sulfasalazine / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D012460:Sulfasalazine