title: Drug rash with eosinophilia and systemic symptoms syndrome following cholestatic hepatitis A: a case report.
abstract: Hepatitis A virus (HAV) infections occur predominantly in children, and are usually self-limiting. However, 75-95% of the infections in adults are symptomatic (mostly with jaundice), with the illness symptoms usually persisting for a few weeks. Atypical manifestations include relapsing hepatitis, prolonged cholestasis, and complications involving renal injury. Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, drug-induced hypersensitivity reaction characterized by skin rash, fever, lymph-node enlargement, and internal organ involvement. We describe a 22-year-old male who presented with acute kidney injury and was diagnosed with prolonged cholestatic hepatitis A. The patient also developed DRESS syndrome due to antibiotic and/or antiviral treatment. To our knowledge, this is the first report of histopathologically confirmed DRESS syndrome due to antibiotic and/or antiviral treatment following HAV infection with cholestatic features and renal injury.
authors.affiliation: Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jihyun
authors.initials: J
authors.lastname: An
authors.forename: Joo Ho
authors.initials: JH
authors.lastname: Lee
authors.forename: Hyojeong
authors.initials: H
authors.lastname: Lee
authors.forename: Eunsil
authors.initials: E
authors.lastname: Yu
authors.forename: Dan Bi
authors.initials: DB
authors.lastname: Lee
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Shim
authors.forename: Sunyoung
authors.initials: S
authors.lastname: Yoon
authors.forename: Yumi
authors.initials: Y
authors.lastname: Lee
authors.forename: Soeun
authors.initials: S
authors.lastname: Park
authors.forename: Han Chu
authors.initials: HC
authors.lastname: Lee
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002439:Cefotaxime / Q000009:adverse effects / Q000627:therapeutic use; D002779:Cholestasis / Q000150:complications / Q000175:diagnosis*; D003587:Cytomegalovirus / Q000235:genetics; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D004802:Eosinophilia / Q000209:etiology; D005076:Exanthema / Q000139:chemically induced* / Q000473:pathology; D015774:Ganciclovir / Q000627:therapeutic use; D006506:Hepatitis A / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007136:Immunoglobulins / Q000627:therapeutic use; D008297:Male; D013577:Syndrome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D004279:DNA, Viral; D007136:Immunoglobulins; D002439:Cefotaxime; D015774:Ganciclovir; D006854:Hydrocortisone