Ajon Alyssa Roseni S, Camara Pia Teresa A
Department of Adult Neurology, Center for Neurological Sciences, Quirino Memorial Medical Center, Quezon City, PHL.
Cureus. 2024 Jul 26;16(7):e65417. doi: 10.7759/cureus.65417. eCollection 2024 Jul.
Drug rash with eosinophilia and systemic symptoms (DRESS) is a rare type of hypersensitivity reaction with an incidence in the general population of one case per 10,000, which may lead to life-threatening complications with a mortality rate of 3.8% to 10%. This condition has been characterized by the following symptoms: skin rash, febrile episodes, lymph node enlargement, and involvement of internal organs, specifically the liver. Common medications associated with these reactions are aromatic anticonvulsants and antibiotics. In this paper, we report a case of a 41-year-old female presenting with head-turning to the right and stiffening of the right upper and lower extremities, with subsequent involvement of the left upper and lower extremities secondary to a left frontal lobe glioma. She had a hypersensitivity reaction to five anticonvulsant medications and was treated with prednisone pulse therapy. This case showed that DRESS syndrome may also manifest with newer non-aromatic anticonvulsants such as levetiracetam and that steroid pulse therapy is effective in resolving the elevated blood parameters as well as skin lesions of patients with DRESS syndrome. The patient's epilepsy responded well to gabapentin without any recurrence of seizure episodes or hypersensitivity reactions.
药物疹伴嗜酸性粒细胞增多和全身症状（DRESS）是一种罕见的超敏反应类型，在普通人群中的发病率为万分之一，可能导致危及生命的并发症，死亡率为3.8%至10%。这种病症的特征如下：皮疹、发热、淋巴结肿大以及内脏受累，特别是肝脏。与这些反应相关的常见药物是芳香族抗惊厥药和抗生素。在本文中，我们报告了一例41岁女性病例，该患者最初表现为头向右侧转动以及右上肢和下肢僵硬，随后因左额叶胶质瘤继发左上肢和下肢受累。她对五种抗惊厥药物发生超敏反应，并接受了泼尼松脉冲疗法治疗。该病例表明，DRESS综合征也可能由新型非芳香族抗惊厥药如左乙拉西坦引发，并且类固醇脉冲疗法对于解决DRESS综合征患者的血液参数升高以及皮肤病变有效。患者的癫痫对加巴喷丁反应良好，未出现癫痫发作或超敏反应复发。
