title: [Venous thrombosis, unrecognized complication of DRESS].
abstract: BACKGROUND
  DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) is a rare syndrome triggered by an immunological reaction to certain drugs and which may be life-threatening as a result of the onset of severe organ involvement. It is characterised by a long period from the time of drug therapy to the onset of actual signs. Herein, we report the case of 42-year-old female patient who developed DRESS one month after beginning allopurinol treatment.
  
  
  METHODS
  A 42-year-old woman was hospitalised for febrile exanthema with facial oedema, polyadenopathy, mononucleosis syndrome, major hypereosinophilia and hepatic cytolysis. A diagnosis was made of DRESS with a RegiSCAR score of 5. The implicated drug was allopurinol, which had been initiated one month earlier. HHV-6 IgM serology was positive. Two days after the start of systemic corticosteroids, the patient developed thrombosis of the internal jugular vein. Other than major hypereosinophilia, no other factors favouring thrombosis were detected. A favourable outcome was achieved under effective anticoagulants and corticosteroids.
  
  
  CONCLUSIONS
  They have been rare reports of venous thrombosis during DRESS. Hypereosinophilia can be involved in the onset of this condition. Prophylaxis with systemic anticoagulants may be necessary in DRESS involving major hypereosinophilia.
authors: Département de soins intensifs, hôpital régional Mahres, route Bohtari, 3060 Sfax, Tunisie. Electronic address: fatma_kaaniche@yahoo.fr.
authors: F
authors: F
authors: Medhioub Kaaniche
authors: Département de soins intensifs, hôpital régional Mahres, route Bohtari, 3060 Sfax, Tunisie.
authors: R
authors: R
authors: Allela
authors: Département de soins intensifs, hôpital régional Gafsa, Tunisie.
authors: N
authors: N
authors: Ben Algia
authors: Département de médecine, hôpital régional Mahres, route Bohtari, 3060 Sfax, Tunisie.
authors: S
authors: S
authors: Cherif
authors: Département de soins intensifs, hôpital régional Gafsa, Tunisie.
authors: M
authors: M
authors: Attar
authors: Département de soins intensifs, hôpital régional Gafsa, Tunisie.
authors: I
authors: I
authors: Frikha
authors: Département de soins intensifs, hôpital régional Gafsa, Tunisie.
authors: M
authors: M
authors: Mnif
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000493:Allopurinol / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D063926:Drug Hypersensitivity Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D010117:Oxypurinol / Q000009:adverse effects; D010328:Patch Tests; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000188:drug therapy; D014812:Vitamin K / Q000037:antagonists & inhibitors
chemical_list: D000305:Adrenal Cortex Hormones; D014812:Vitamin K; D000493:Allopurinol; D006493:Heparin; D010117:Oxypurinol
keywords: Allopurinol; DRESS; Drug hypersensitivity; Eosinophilia; Hypersensibilité médicamenteuse; Thrombose veineuse; Venous thrombosis; Éosinophilie