DRESS Syndrome Associated with Carbamazepine: A Case Report

Abstract

Abstract DRESS Syndrome is a severe toxicity. Considered a rare, serious and multi-organ reaction, frequently associated with antiepileptic drugs (phenytoin, carbamazepine, lamotrigine). The objective of this article is to describe the clinical characteristics, complementary tests, their diagnosis, evolution and treatment. We present a 31-year-old patient who is admitted to the Clinic Service of the SOLCA Hospital in Riobamba with a history of sporadic seizures with no apparent cause treated with carbamazepine and lamotrigine. DRESS syndrome presents a clinical triad of fever, rash, and multi-organ disorder). DRESS syndrome begins late, slowly evolves and clinically similar to infectious processes, which is why it is frequently misdiagnosed. Its incidence is very low in individuals exposed to various medications. The correct diagnosis is difficult especially in professionals not trained in the skin specialty. A misdiagnosis or delay in it increases mortality by up to 30%. The fundamental basis in the treatment of DRESS syndrome is to immediately withdraw the triggering drug and use systemic corticosteroid pulses, which will undoubtedly save the patient's life. It is concluded that DRESS Syndrome can be fatal, so an early diagnosis is important. Due to its classic clinical triad of fever, rash and multi-organ involvement, there is difficulty in its diagnosis, especially when there is no evaluation by a skin specialist. However, once correctly diagnosed, it has a satisfactory evolution.

Keywords

• dress syndrome, carbamazepine, lamotrigine, rash, multiorgan involvement.