Sulfasalazine-induced drug reaction with eosinophilia and systemic symptoms (DRESS) with concomitant acute chikungunya virus infection: possible role of new viral trigger.

Abstract

Drug reaction with eosinophilia and systemic symptoms (DRESS) is designated as a potentially lethal adverse drug effect with characteristic signs and symptoms such as skin rash, fever, leucocytosis with eosinophilia or atypical lymphocytes, lymphadenopathy and liver or renal dysfunction. In addition to most commonly implicated drug category (aromatic anticonvulsants), lamotrigine, sulfonamides, dapsone and abacavir may also induce this syndrome. We describe here a case a sulfasalazine-induced DRESS with coexisting chikungunya fever. The shared presentation of fever with rash in both conditions made it a challenging diagnosis. Sulfasalazine hypersensitivity manifesting as DRESS has rarely been reported. Furthermore, we document chikungunya virus (CV) as a possible triggering agent for DRESS. To the best of our knowledge, CV as a viral aetiology in DRESS has not been reported previously in the literature.

• Authors: Abheek Sil, Moni Sankar Bhattacharjee, Atanu Chandra, Jayasri Das Pramanik
• Journal: BMJ case reports (BMJ Case Rep) Vol. 14 Issue 10 (Oct 12 2021) ISSN: 1757-790X [Electronic] England
• PMID: 34642219 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Sulfasalazine

Topics

• Chikungunya Fever (complications, diagnosis)
• Drug Hypersensitivity Syndrome (diagnosis, etiology)
• Eosinophilia
• Exanthema
• Humans
• Sulfasalazine (adverse effects)