Drug reaction with eosinophilia and systemic symptoms (DRESS)
syndrome is a severe multiorgan
drug induced idiosyncratic reaction. As the
name suggests it is characterized by peripheral
eosinophilia and systemic symptoms like
fever,
rash,
lymphadenopathy,
liver failure.
Incidence is around 11000 to 110,000
drug exposures and has a high
mortality if not diagnosed and treated timely.
Diagnosis is difficult and challenging due to the diversity of symptoms this
syndrome has, hence scoring systems like the RegiSCAR and
Japanese criteria may be used. Mortality rate is around 10-20% and mostly due to
liver failure. Most important step in
treatment is withdrawal of the offending
drug and supportive line of
therapy with
corticosteroids forming the mainstay of
therapy. This
paper reports two such cases which were a diagnostic dilemma and timely withdrawal of the offending
drug and
corticosteroids changed the
course of the condition completely.