title: Pentoxifylline-induced drug rash with eosinophilia and systemic symptoms (DRESS) in a patient with caffeine intolerance.
abstract: BACKGROUND
  Drug rash with eosinophilia and systemic symptoms (DRESS) is a severe drug reaction characterised by rash, eosinophilia and systemic involvement.
  
  
  METHODS
  We report a case of DRESS induced by pentoxifylline used for the treatment of severe alcoholic hepatitis, in a patient with longstanding caffeine intolerance. A history of intolerance to caffeine and other methylxanthines is listed as a contraindication to the use of pentoxifylline, yet this precaution is not mentioned in alcoholic hepatitis treatment guidelines.
  
  
  CONCLUSIONS
  Prescribers should always seek a history of intolerance to caffeine and related compounds prior to use of pentoxifylline, as severe life threatening reactions can occur.
authors.affiliation: AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, Australia; ; Sydney Medical School, University of Sydney, Australia;
authors.forename: Rebecca B
authors.initials: RB
authors.lastname: Saunderson
authors.forename: Roger
authors.initials: R
authors.lastname: Garsia
authors.forename: Alexander P
authors.initials: AP
authors.lastname: Headley
authors.forename: Geoffrey W
authors.initials: GW
authors.lastname: McCaughan
authors.forename: Sandra
authors.initials: S
authors.lastname: O'Toole
authors.forename: Simone I
authors.initials: SI
authors.lastname: Strasser
keywords: DRESS; adverse drug reaction; alcoholic hepatitis; caffeine; eosinophilia; methylxanthines; pentoxifylline