title: DRESS syndrome potentially induced by allopurinol and triggered by influenza vaccine.
abstract: Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome, also known as drug-induced hypersensitivity syndrome (DHIS), is an acute, potentially life-threatening disease that includes skin rash, fever, haematological abnormalities and multiorgan involvement. Although its aetiopathogenesis is not exactly known, it is thought that inefficient drug detoxification leading to the accumulation of drug reactive metabolites causes autoimmune responses in skin and some internal organs, alters immune responses and induces reactivation of viral infections in people who have genetic predisposition. To the best of our knowledge, only one case of DRESS syndrome has been reported after delivery of the influenza vaccine, but the drug that induced the reaction in that case was sulfasalazine. We report a case of a 64-year-old woman, receiving allopurinol, who developed DRESS syndrome after taking the influenza vaccine.
authors.affiliation: Department of Dermatology, Sakarya University, School of Medicine, Sakarya, Turkey.
authors.forename: Berna
authors.initials: B
authors.lastname: Solak
authors.affiliation: Department of Dermatology, Sakarya University Training and Research Hospital, Sakarya, Turkey.
authors.forename: Bahar Sevimli
authors.initials: BS
authors.lastname: Dikicier
authors.affiliation: Department of Dermatology, Sakarya University, School of Medicine, Sakarya, Turkey.
authors.forename: Rabia Oztas
authors.initials: RO
authors.lastname: Kara
authors.affiliation: Department of Dermatology, Sakarya University, School of Medicine, Sakarya, Turkey.
authors.forename: Teoman
authors.initials: T
authors.lastname: Erdem
mesh_terms: D000493:Allopurinol / Q000009:adverse effects*; D063926:Drug Hypersensitivity Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D015654:Herpesvirus 6, Human / Q000502:physiology; D006801:Humans; D007252:Influenza Vaccines / Q000009:adverse effects*; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D016896:Treatment Outcome; D014775:Virus Activation
chemical_list: D007252:Influenza Vaccines; D000493:Allopurinol; D008775:Methylprednisolone