DRESS syndrome - Drug Reaction with Eosinophilia and Systemic Symptoms, also known as drug hypersensitivity reactions.
These commonly present 2 weeks after initiating a new medication with:
- Fever
- Rash: papular, macular, bullous
- Lymphadenopathy
- Arthralgias
- Hepatitis
- Eosinophilia
Medications which are commonly associated with DRESS syndrome include "aromatic" anticonvulsants (phenytoin, carbamazepine, and phenobarbitol) - but can occur with other anticonvulsants as well. Other classic DRESS syndromes occur with NSAIDs, abacavir, and allopurinol. Treatment revolves around discontinuing the culprit agent, supportive care, and perhaps steroid therapy.
In the case of abacavir, hypersensitivity reactions are known to occur more frequently in those who are HLA B5701-positive, and screening programs are now widely used to prevent this adverse reaction.
Here is a short and useful review article from J Emerg Med that U of T residents can read through the library:
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