title: [Severe cholestatic hepatitis revealing a DRESS syndrome].
abstract: BACKGROUND
  Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a drug-induced hypersensitivity syndrome, characterized by rash, hyereosinophilia and multiorgan failure, including cytolytic hepatitis.
  
  
  METHODS
  A 75-year-old man, treated with amoxicillin/clavulanic acid, presented with jaundice and disabling pruritus associated with severe cholestatic hepatitis, related to a DRESS syndrome. Because of the persistence of cholestasis and the severity of pruritus, a treatment with corticosteroids and plasma exchanges was initiated, allowing a rapid and complete remission.
  
  
  CONCLUSIONS
  Amoxicillin/clavulanic acid, although rarely described in the literature, is a rare cause of DRESS syndrome. Severe cholestatic hepatitis associated with disabling pruritus may be one of the systemic manifestations, with a good prognosis using corticosteroids and plasma exchanges.
authors.affiliation: Service de médecine interne, université Paris Descartes, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Droz
authors.forename: M
authors.initials: M
authors.lastname: Thiebaut
authors.forename: B
authors.initials: B
authors.lastname: Terrier
authors.forename: A
authors.initials: A
authors.lastname: Bérézné
authors.forename: P
authors.initials: P
authors.lastname: Sogni
authors.forename: F
authors.initials: F
authors.lastname: Beuvon
authors.forename: L
authors.initials: L
authors.lastname: Guillevin
authors.forename: L
authors.initials: L
authors.lastname: Mouthon
mesh_terms: D000368:Aged; D001706:Biopsy; D002779:Cholestasis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D063926:Drug Hypersensitivity Syndrome / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006505:Hepatitis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D012720:Severity of Illness Index
keywords: Amoxicillin/clavulanic acid; Amoxicilline/acide clavulanique; Cholestatic hepatitis; DRESS; Hépatite cholestatique; Plasma exchanges; Prurit; Pruritus; Échanges plasmatiques