DRESS syndrome, a differencial diagnosis in late postoperative complications
DOI:
https://doi.org/10.23938/ASSN.0586Keywords:
Drug-induced hypersensitivity syndrome. Hypersensitivity. Drug hypersensitivity reactions. Drug exposure.Abstract
The DRESS syndrome (drug rash with eosinophilia and systemic symptoms) is a serious pharmacodermia which must be taken into account when establishing an optimal early treatment to prevent a systemic and potentially lethal evolution.
Pharmacodermias are the third most frequent cause of adverse effects during surgical hospitalization, after nosocomial infections and intraoperative complications. In most cases, they pose a challenge to the surgeon, since their onset is nonspecific and, therefore, can be easily mistaken for a surgery complication.
We present the case of a 54-year-old man, healthy and without relevant background, who was operated on two times due to spontaneous abdominal bleeding. Three weeks after the last surgery, and coinciding with the administration of oral metamizole, the patient developed a DRESS syndrome. The initial unspecific deterioration, characteristic of this syndrome, is the main cause of the delay in diagnosis and correct treatment, causing the resulting evolution to systemic affectation.
Downloads
References
- ARANAZ-ANDRÉS JM, AIBAR-REMÓN C, VITALLER-MURILLO J, RUIZ-LÓPEZ P, LIMÓN-RAMÍREZ R, TEROL-GARCÍA E et al. Incidence of adverse events related to health care in Spain: results of the Spanish National Study of Adverse Events. J Epidemiol Community Health 2008; 62: 1022-1029. https://doi.org/10.1136/jech.2007.065227
- ARANAZ-ANDRÉS JM, RUIZ-LÓPEZ R, AIRBAR-REMÓN C, REQUENA-PUCHE J, AGRA-VARELA Y, LIMÓN-RAMÍREZ R et al. Sucesos adversos en cirugía general y de aparato digestivo en los hospitales españoles. Cir Esp 2007; 82: 268-277. https://doi.org/10.1016/S0009-739X(07)71724-4
- RAMOS L. Síndrome Dress. Presentación de un caso y actualización. Rev Argent Dermatol 2013; 94:3. https://rad-online.org.ar/2013/10/01/sindrome-dress-presentacion-de-un-caso-y-actualizacion/
- CACOUB P, MUSETTE P, DESCAMPS V, MEYER O, SPEIRS C, FINZI L et al. The Dress syndrome: a literatura review. Am J Med 2011; 124: 588-597. https://doi.org/10.1016/j.amjmed.2011.01.017
- MUCIÑO-BERMEJO J, DÍAZ DE LEÓN-PONCE M, RIONES-VEGA CG, GUERRERO-HERNÁNDEZ A, SANDOVAL-AYALA OI,SÁENZ-CORONADO AG et al. Síndrome de Dress. Reporte de un caso clínico. Rev Med Inst Mex Seguro Soc 2013; 51: 330-335.
- HUSAIN Z, REDDY BY, SCHWARTZ RA. Dress syndrome: Part I. Clinical perspectives. J Am Acad Dermatol 2013; 68: 693.e1-14. https://doi.org/10.1016/j.jaad.2013.01.033
- SHIOHARA T, KANO Y. Drug reaction with eosinophilia and systemic symptoms (Dress): incidence, pathogenesis and management. Expert Opin Drug Saf 2016; 21: 1-9. https://doi.org/10.1080/14740338.2017.1270940
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2019 Anales del Sistema Sanitario de Navarra
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
La revista Anales del Sistema Sanitario de Navarra es publicada por el Departamento de Salud del Gobierno de Navarra (España), quien conserva los derechos patrimoniales (copyright ) sobre el artículo publicado y favorece y permite la difusión del mismo bajo licencia Creative Commons Reconocimiento-CompartirIgual 4.0 Internacional (CC BY-SA 4.0). Esta licencia permite copiar, usar, difundir, transmitir y exponer públicamente el artículo, siempre que siempre que se cite la autoría y la publicación inicial en Anales del Sistema Sanitario de Navarra, y se distinga la existencia de esta licencia de uso.
