Paydas Saime, Balal Mustafa, Kocabas Firat, Ay Nurettin
Department of Nephrology, Faculty of Medicine, Cukurova University, Adana, Turkey.
Department of Internal Medicine, Faculty of Medicine, Cukurova University, Adana, Turkey.
Saudi J Kidney Dis Transpl. 2017 Jul-Aug;28(4):934-936.
Drug reaction with eosinophilia and systemic symptoms (DRESS) or drug-induced hypersensitivity is a severe adverse drug-induced reaction. Aromatic anticonvulsants, such as phenytoin, phenobarbital, and carbamazepine, and some drugs, can induce DRESS. Atypical crystalluria can be seen in patients treated with amoxycillin or some drugs and can cause acute renal failure. We describe a 66-year-old man who presented fever and rash and acute renal failure three days after starting amoxycillin. He was also using phenytoin because of cerebral metastatic lung cancer. Investigation revealed eosinophilia and atypical crystalluria. The diagnosis of DRESS syndrome was made, amoxicillin was stopped, and dose of phenytoin was reduced. No systemic corticosteroid therapy was prescribed. Symptoms began to resolve within three to four days. The aim of this paper is to highlight the importance of microscopic examination of urine in a case with acute renal failure and skin lesions to suspect DRESS syndrome.
药物性嗜酸性粒细胞增多症及系统症状（DRESS）或药物性超敏反应是一种严重的药物不良反应。芳香族抗惊厥药，如苯妥英、苯巴比妥和卡马西平，以及一些药物，可诱发DRESS。使用阿莫西林或某些药物的患者可出现非典型结晶尿，并可导致急性肾衰竭。我们报告一名66岁男性，在开始使用阿莫西林三天后出现发热、皮疹和急性肾衰竭。他因脑转移性肺癌还在使用苯妥英。检查发现嗜酸性粒细胞增多和非典型结晶尿。诊断为DRESS综合征，停用阿莫西林，并减少苯妥英剂量。未给予全身糖皮质激素治疗。症状在三到四天内开始缓解。本文的目的是强调在怀疑为DRESS综合征的急性肾衰竭和皮肤病变病例中，尿液显微镜检查的重要性。
