Cho Ara, Lee Jeong-Moo, Hong Kwangpyo, Han Eui Soo, Hong Suk Kyun, Choi YoungRok, Yi Nam-Joon, Lee Kwang-Woong, Suh Kyung-Suk
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Ann Hepatobiliary Pancreat Surg. 2021 Nov 30;25(4):551-555. doi: 10.14701/ahbps.2021.25.4.551.
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare delayed-type hypersensitivity reaction that causes skin abnormalities and mucosal involvement of the entire body. This is a case report of DRESS occurring in a liver transplantation recipient after taking drugs. A 57-year-old female patient with hepatocellular carcinoma underwent living donor liver transplantation in April 2019. She had no previous medical histories relevant to allergic diseases. There were no adverse events during hospitalization. She was admitted to evaluate and treat a headache occurring at one month after transplantation. However, she suffered from adverse drug reactions after taking anticonvulsants, showing skin rash, itching sense, and fever with eosinophilia. Piperacillin/Tazoperan was administered for ten days as an empirical antibiotic. Skin biopsy was performed on postoperative day 106 for erythematous maculopapular rash in the arms, legs, and torso. Her symptoms improved after discontinuation of the suspected medication with conservative skin treatment and high-dose steroid treatment. This case suggests that suspicion of drug history is essential for early diagnosis and management of DRESS.
药物超敏反应伴嗜酸性粒细胞增多和全身症状（DRESS）综合征是一种罕见的迟发型超敏反应，可导致皮肤异常和全身黏膜受累。本文报告1例肝移植受者用药后发生DRESS的病例。一名57岁肝细胞癌女性患者于2019年4月接受活体肝移植。她既往无过敏性疾病相关病史。住院期间无不良事件发生。她因移植后1个月出现头痛入院评估和治疗。然而，她服用抗惊厥药后出现药物不良反应，表现为皮疹、瘙痒感和发热伴嗜酸性粒细胞增多。哌拉西林/他唑巴坦作为经验性抗生素使用了10天。术后第106天对双臂、双腿和躯干的红斑性斑丘疹进行了皮肤活检。停用可疑药物并进行保守皮肤治疗和大剂量类固醇治疗后，她的症状有所改善。该病例提示，怀疑用药史对DRESS的早期诊断和管理至关重要。
