title: Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) induced by carbamazepine: a case report and literature review.
abstract: Drug-induced hypersensitivity or Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) is a severe adverse drug-induced reaction. Diagnosing DRESS is challenging due to the diversity of cutaneous eruption and organs involved. Most of the aromatic anticonvulsants, such as phenytoin, phenobarbital, and carbamazepine, can induce DRESS. Culprit drug withdrawal and corticosteroids constituted the mainstay of DRESS treatment. We describe a 6 year-old boy who presented fever and rash 4 weeks after starting carbamazepine. Investigation revealed leukocytosis, atypical lymphocytosis, and elevated serum transaminases. The diagnosis of DREES syndrome was made, Carbamazepine was stopped and replaced initially by Clobazam and by Valproic acid after discharge, no systemic corticotherapy was prescribed. Symptoms began to resolve within two weeks, and by one month later her laboratory values had returned to normal. The aim of this work is to raise awareness general practitioner and pediatricians to suspect Dress syndrome in patients who present with unusual complaints and skin findings after starting any antiepileptic drug.
authors.affiliation: Pediatric Department, Hassan II University Hospital, Fes, Morocco.
authors.forename: Nissrine
authors.initials: N
authors.lastname: E L omairi
authors.affiliation: Pediatric Department, Hassan II University Hospital, Fes, Morocco.
authors.forename: Sanae
authors.initials: S
authors.lastname: Abourazzak
authors.affiliation: Pediatric Department, Hassan II University Hospital, Fes, Morocco.
authors.forename: Sanae
authors.initials: S
authors.lastname: Chaouki
authors.affiliation: Pediatric Department, Hassan II University Hospital, Fes, Morocco.
authors.forename: Samir
authors.initials: S
authors.lastname: Atmani
authors.affiliation: Pediatric Department, Hassan II University Hospital, Fes, Morocco.
authors.forename: Moustapha
authors.initials: M
authors.lastname: Hida
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D002220:Carbamazepine / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D063926:Drug Hypersensitivity Syndrome / Q000175:diagnosis / Q000209:etiology*; D004827:Epilepsy / Q000188:drug therapy; D006801:Humans; D008297:Male
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine
keywords: DRESS syndrome; Epilepsy; carbamazepine; rash