.: OLGU SUNUMU
COVID-19 Hastasında Gelişen Dress Sendromu Olgusu: İlaca Bağlı mı, Hastalığa Bağlı mı?
Dress Syndrome Case in COVID-19 Patient: Drug-Induced or Disease-Related?
Turkiye Klinikleri J Med Sci.2020;40(4):475-9
doi: 10.5336/medsci.2020-78921
Makale Dili: TR
Tam Metin
ÖZET
Eozinofili ve sistemik semptomlarla ilaç reaksiyonu [Drug rash with eoshinophilia and systemic symptoms (DRESS)] sendromu nadir görülen, yaklaşık %10 oranında mortal seyredebilen ilaç reaksiyonlarından biridir. DRESS sendromu, klinik olarak yaygın makülopapüler ekzantem, çeşitli hematolojik anormallikler, karaciğer ve böbrek fonksiyon bozuklukları, ateş ve lenfadenopati ile karakterizedir. DRESS sendromunun etiyolojisinde pek çok ilaç bulunup Fenitoin, Karbamazepin, fenobarbital, Allopürinol, Abakavir ve Sülfonamidler en çok bildirilenlerdendir. Hidroksiklorokin , in vitro gösterilen antiviral etkileri nedeni ile koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] hastalığına karşı tedavide kullanılmaktadır. Hidroksiklorokinin, literatürde bildirilen dermatolojik yan etkilerinden bazıları; alopesi, ciltte hiperpigmentasyon ve kaşıntı olup, aşırı duyarlılık reaksiyonları olan Steven-Johnson sendromu/toksik epidermal nekroliz, akut generalize ekzantematöz püstüloz ve DRESS sendromu da bildirilmiştir. Biz burada, COVID-19 hastalığı tedavisi sırasında gelişen yaygın cilt döküntüsü ve sistemik bulguları ile DRESS sendromu tanısı koyduğumuz bir olgumuzu, pandemi döneminde gelişebilecek ilaç reaksiyonları ve COVID-19'a bağlı deri tutulumlarına dikkat çekmek açısından sunmak istedik. Aynı zamanda, COVID-19 hastalığı seyrindeki ilaç reaksiyonu ve cilt tutulumu karmaşasına dikkat çekmek istedik.
Anahtar Kelimeler: COVID-19; DRESS sendromu; ilaç aşırı duyarlılığı
Eozinofili ve sistemik semptomlarla ilaç reaksiyonu [Drug rash with eoshinophilia and systemic symptoms (DRESS)] sendromu nadir görülen, yaklaşık %10 oranında mortal seyredebilen ilaç reaksiyonlarından biridir. DRESS sendromu, klinik olarak yaygın makülopapüler ekzantem, çeşitli hematolojik anormallikler, karaciğer ve böbrek fonksiyon bozuklukları, ateş ve lenfadenopati ile karakterizedir. DRESS sendromunun etiyolojisinde pek çok ilaç bulunup Fenitoin, Karbamazepin, fenobarbital, Allopürinol, Abakavir ve Sülfonamidler en çok bildirilenlerdendir. Hidroksiklorokin , in vitro gösterilen antiviral etkileri nedeni ile koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] hastalığına karşı tedavide kullanılmaktadır. Hidroksiklorokinin, literatürde bildirilen dermatolojik yan etkilerinden bazıları; alopesi, ciltte hiperpigmentasyon ve kaşıntı olup, aşırı duyarlılık reaksiyonları olan Steven-Johnson sendromu/toksik epidermal nekroliz, akut generalize ekzantematöz püstüloz ve DRESS sendromu da bildirilmiştir. Biz burada, COVID-19 hastalığı tedavisi sırasında gelişen yaygın cilt döküntüsü ve sistemik bulguları ile DRESS sendromu tanısı koyduğumuz bir olgumuzu, pandemi döneminde gelişebilecek ilaç reaksiyonları ve COVID-19'a bağlı deri tutulumlarına dikkat çekmek açısından sunmak istedik. Aynı zamanda, COVID-19 hastalığı seyrindeki ilaç reaksiyonu ve cilt tutulumu karmaşasına dikkat çekmek istedik.
Anahtar Kelimeler: COVID-19; DRESS sendromu; ilaç aşırı duyarlılığı
ABSTRACT
Drug rash with eoshinophilia and systemic symptoms (DRESS) syndrome is one of the rare drug reactions with a mortality rate of approximately 10%. Clinically the DRESS syndrome is characterized by diffuse maculopapular exanthema, various hematological abnormalities, liver and kidney dysfunction, fever, and lymphadenopathy. There are many drugs in the etiology of DRESS syndrome, and Phenytoin, Carbamazepine, phenobarbital, Allopurinol, Abacavir and Sulfonamides are among the most reported. Hydroxychloroquine is used in the treatment of COVID-19 disease due to its antiviral effects shown in vitro. Some of the dermatological side effects of Hydroxychloroquine reported in the literature are alopecia, hyperpigmentation and itching of the skin, as well as Steven-Johnson syndrome/toxic epidermal necrolysis, acute generalized exantomatous pustulosis, DRESS syndrome, which are hypersensitivity reactions. Here, we wanted to present a patient who was diagnosed as DRESS syndrome due to his widespread skin rash and systemic signs that developed during the treatment of COVID-19 disease in order to draw attention to the drug reactions that may develop during the pandemic and skin involvement due to COVID-19. At the same time, we wanted to draw attention to the complexity of drug reaction or skin involvement in the course of COVID-19 disease.
Keywords: COVID-19; DRESS syndrome; drug hypersensitivity
Drug rash with eoshinophilia and systemic symptoms (DRESS) syndrome is one of the rare drug reactions with a mortality rate of approximately 10%. Clinically the DRESS syndrome is characterized by diffuse maculopapular exanthema, various hematological abnormalities, liver and kidney dysfunction, fever, and lymphadenopathy. There are many drugs in the etiology of DRESS syndrome, and Phenytoin, Carbamazepine, phenobarbital, Allopurinol, Abacavir and Sulfonamides are among the most reported. Hydroxychloroquine is used in the treatment of COVID-19 disease due to its antiviral effects shown in vitro. Some of the dermatological side effects of Hydroxychloroquine reported in the literature are alopecia, hyperpigmentation and itching of the skin, as well as Steven-Johnson syndrome/toxic epidermal necrolysis, acute generalized exantomatous pustulosis, DRESS syndrome, which are hypersensitivity reactions. Here, we wanted to present a patient who was diagnosed as DRESS syndrome due to his widespread skin rash and systemic signs that developed during the treatment of COVID-19 disease in order to draw attention to the drug reactions that may develop during the pandemic and skin involvement due to COVID-19. At the same time, we wanted to draw attention to the complexity of drug reaction or skin involvement in the course of COVID-19 disease.
Keywords: COVID-19; DRESS syndrome; drug hypersensitivity
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