Successful treatment of drug reaction with eosinophilia and systemic symptoms secondary to multiple viral infections and nonsteroidal anti-inflammatory drugs in a patient with autoimmune hepatitis
Abstract
Rationale: Drug reaction with eosinophilia and systemic symptoms (DRESS), a potentially life-threatening drug-induced adverse reaction, can damage various organs, but is under-recognized in clinical practice.
Patient concerns: A 44-year-old female was admitted due to abnormal liver function for half a month. During hospitalization, she developed fever, rash, pleural effusion, and multiple organ dysfunction.
Diagnoses: Probable DRESS was considered, except for cytomegalovirus, circovirus, Epstein-Barr virus, and herpes simplex virus infection as well as autoimmune hepatitis.
Interventions: Antiviral and antibacterial infection drugs and nonsteroidal anti-inflammatory drugs were used, but fever was not improved. After the diagnosis of "probable DRESS," methylprednisolone and immunoglobulin were added. Then, fever was controlled.
Outcomes: Finally, her temperature normalized, and rashes around right quadrant abdomen and limbs gradually decreased. Lung computed tomography scan was repeated, indicating the improvement of pneumonia and pleural effusion. Serum bilirubin and immunoglobulin G levels also decreased.
Lessons: DRESS should be considered in a patient suffering from viral infection and receiving potentially causative drugs, when fever, rash, and multiple organ dysfunction occur.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Artificial Intelligence in Medicine: Cross-Sectional Study Among Medical Students on Application, Education, and Ethical Aspects
- Information quality of videos related to esophageal cancer on tiktok, kwai, and bilibili: a cross-sectional study
- The quality and reliability of short videos about hypertension on TikTok: a cross-sectional study
- Quality and reliability evaluation of pancreatic cancer-related video content on social short video platforms: a cross-sectional study
- Quality and reliability of pediatric pneumonia related short videos on mainstream platforms: cross-sectional study
- Association between metabolic score for insulin resistance (METS-IR) and hypertension: a cross-sectional study based on NHANES 2007–2018
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.