title: First case of drug rash eosinophilia and systemic symptoms due to boceprevir.
abstract: Boceprevir and telaprevir are 2 specific inhibitors of the hepatitis C (HCV) serine protease 3. Cutaneous side effects have been reported with high frequency, essentially rash, and dry skin. We report a case of drug rash with eosinophilia and systemic symptoms (DRESS) due to boceprevir. A 56-year-old African woman with chronic hepatitis C complicated with cirrhosis and cryoglobulinemia received pegylated interferon alfa-2a (PegIFN) and ribavirin (RBV) for 4 weeks and then boceprevir was added. She was also co-infected with HIV state A2. Eight weeks after adding boceprevir she developed a generalized maculopapular exanthema with fever, facial oedema, apparition of lymph node and alteration of the general state. She presented an eosinophilia (up to 3.0 × 10(9)cells/L), no biological inflammatory syndrome. The computed tomography revealed several lymph nodes located in the abdominal and inguinal areas. The cutaneous biopsy was consistent with a drug rash reaction. The HCV treatment was stopped and the patient was treated with topical steroids. Cutaneous and systemic symptoms disappeared in few weeks. Boceprevir was considered the culprit drug. We report to our knowledge the first case of DRESS due to boceprevir.
authors: Dermatology Department, Inserm, U905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, University of Normandy, Rouen, France. Electronic address: agnessamain@hotmail.com.
authors: Agnès
authors: A
authors: Samain
authors: Dermatology Department, Inserm, U905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, University of Normandy, Rouen, France.
authors: Anne-Bénédicte
authors: AB
authors: Duval-Modeste
authors: Dermatology Department, Inserm, U905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, University of Normandy, Rouen, France.
authors: Pascal
authors: P
authors: Joly
authors: Dermatology Department, Inserm, U905, Institute for Research and Innovation in Biomedicine, Rouen University Hospital, University of Normandy, Rouen, France.
authors: Céline
authors: C
authors: Leblanc
authors: Pharmacovigilance Department, Rouen University Hospital, University of Normandy, Rouen, France.
authors: Nathalie
authors: N
authors: Massy
authors: Pathology Department, Rouen University Hospital, University of Normandy, Rouen, France.
authors: Philippe
authors: P
authors: Courville
authors: Hepatogastroenterology Department, Rouen University Hospital, University of Normandy, Rouen, France.
authors: Odile
authors: O
authors: Goria
authors: Hepatogastroenterology Department, Rouen University Hospital, University of Normandy, Rouen, France.
authors: Ghassan
authors: G
authors: Riachi
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects*; D063926:Drug Hypersensitivity Syndrome / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D016174:Hepacivirus / Q000187:drug effects / Q000201:enzymology; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008875:Middle Aged; D011392:Proline / Q000009:adverse effects / Q000031:analogs & derivatives*; D012307:Risk Factors; D015842:Serine Proteinase Inhibitors / Q000009:adverse effects
chemical_list: D000998:Antiviral Agents; D015842:Serine Proteinase Inhibitors; C512204:N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide; D011392:Proline
keywords: Boceprevir; Drug rash eosinophilia and systemic symptoms; Hepatitis C