Drug reaction with eosinophilia and systemic symptoms (DRESS) induced by allopurinol: A case report

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe drug-induced reaction. It is characterized by fever, skin eruption, lymphadenopathy, haematological abnormalities and involvement of internal organs. We describe the case of a 74-year-old woman, who developed DRESS, due to intake of allopurinol. She was admitted to the hospital 6 weeks after she had begun taking allopurinol with fever, maculopapular erythema, lymphadenopathy and general malaise. Blood tests revealed eosinophilia, lymphocytosis, severe inflammation and involvement of liver and kidney. PET-CT showed increased FDG uptake in several lymphnotes. She was diagnosed with DRESS, the culprit drug was withdrawn and she was given oral prednisolone. Symptoms resolved within a month. DRESS is a serious condition with mortality up to 10%. It is associated with diagnostic difficulties, as the clinical symptoms are variable and may mimic other conditions. Our case focuses on the recognition and treatment of DRESS. (C) 2013 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.