DRESS-syndrome on sulfasalazine and naproxen treatment for juvenile idiopathic arthritis and reactivation of human herpevirus 6 in an 11-year-old Caucasian boy.
DRESS-syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is a severe drug-induced hypersensitivity syndrome characterized by diffuse maculopapular rash, lymphadenopathy, multivisceral involvement, eosinophilia and atypical lymphocytes with a mortality rate of 10-40% (Seminars in Cutaneous Medicine and Surgery, 1, 250). It is described in adults treated with aromatic antiepileptics and less frequently with sulphonamides, and non-steroidal anti-inflammatory drugs (Clinics in Dermatology, 23, 171; Pediatrics, 108, 485). We report on an 11-year-old Caucasian boy hospitalized with a skin eruption, lymphadenopathy, acute hepatitis, renal tubular involvement, haematological abnormalities and human-herpevirus-6 reactivation, treated with sulfasalazine and naproxen for juvenile idiopathic arthritis (JIA). This is the first report in children with rheumatic disease and highlights the possibility of sulfasalazine and naproxen-induced-DRESS-syndrome in children with JIA.
Piñana
E
E
Clinical Pharmacology Department, Hospital Universitario La Paz, School of Medicine, Universidad Autónoma de Madrid, Spain.
Lei
S H
SH
Merino
R
R
Melgosa
M
M
De La Vega
R
R
Gonzales-Obeso
E
E
Ramírez
E
E
Borobia
A
A
Carcas
A
A
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000188:drug therapy; D002648:Child; D003875:Drug Eruptions / Q000209:etiology*; D004359:Drug Therapy, Combination; D015654:Herpesvirus 6, Human / Q000302:isolation & purification; D006801:Humans; D008297:Male; D009288:Naproxen / Q000009:adverse effects* / Q000627:therapeutic use; D019349:Roseolovirus Infections / Q000821:virology; D012460:Sulfasalazine / Q000009:adverse effects* / Q000627:therapeutic use; D013577:Syndrome; D014775:Virus Activation / Q000187:drug effects
D000894:Anti-Inflammatory Agents, Non-Steroidal; D012460:Sulfasalazine; D009288:Naproxen