Rahmani Hamid, Mohebbi Niayesh, Sajjadi-Jazi Sayed Mahmoud
Department of pharmacotherapy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism sciences institute, Tehran University of Medical Sciences, Tehran, Iran.
Hosp Pharm. 2021 Dec;56(6):646-649. doi: 10.1177/0018578720946764. Epub 2020 Jul 27.
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and life-threatening hypersensitivity reaction. It is characterized by fever, skin lesions, and internal organ involvement. Sorafenib is a tyrosine kinase inhibitor that is used for the treatment of certain cancers such as hepatocellular, renal cell, and thyroid cancer. The case is a 40 years old man who presented with fever, generalized skin rash, and pruritus. The patient has received sorafenib for the treatment of medullary thyroid cancer (MTC) from 3 weeks ago. Following presentation, the drug was discontinued and causality was assessed by scoring system RegiSCAR and Naranjo scale that showed a probable DRESS. There was no internal organ involvement based on the laboratory evaluations. The considerable abnormality was eosinophilia among patient's laboratory tests. Antihistamines and topical and systemic corticosteroids were utilized for the management of the symptoms. To the best of our knowledge, this is the first case report of DRESS syndrome by sorafenib in the patients with MTC. Clinicians should be aware of sign and symptoms suggesting DRESS syndrome of sorafenib.
药物超敏反应伴嗜酸性粒细胞增多和全身症状（DRESS）是一种罕见且危及生命的超敏反应。其特征为发热、皮肤病变和内脏器官受累。索拉非尼是一种酪氨酸激酶抑制剂，用于治疗某些癌症，如肝细胞癌、肾细胞癌和甲状腺癌。该病例为一名40岁男性，出现发热、全身性皮疹和瘙痒。患者3周前开始接受索拉非尼治疗甲状腺髓样癌（MTC）。就诊后，停用该药物，并通过RegiSCAR评分系统和纳伦霍量表评估因果关系，结果显示可能为DRESS。根据实验室评估，无内脏器官受累。患者实验室检查中显著异常为嗜酸性粒细胞增多。使用抗组胺药以及局部和全身用皮质类固醇来管理症状。据我们所知，这是首例关于索拉非尼导致MTC患者发生DRESS综合征的病例报告。临床医生应了解提示索拉非尼DRESS综合征的体征和症状。
