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Successful treatment of DRESS syndrome with plasmapheresis during the course of sero-≠‚Äźnegative autoimmune encephalitis: a case report

Amybel Belladonna Taylor, May Lynn Yeap, Peta Sharples, Mohamed Osman Eltahir Babiker.

Abstract
Background: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome manifests as a significant, medication-induced, adverse reaction with cutaneous, hematological and multi-organ involvement. Sero-negative autoimmune encephalitis is inflammation of the brain secondary to autoimmune processes in the absence of an identifiable autoantibody.

Case presentation: We present a pediatric case of sero-negative autoimmune encephalitis who subsequently developed DRESS syndrome as a result of exposure to ceftriaxone, omeprazole or acyclovir. She did not respond to either high-dose steroids or intravenous immunoglobulins (IVIG). Plasmapheresis was successful in treating symptoms relevant to both DRESS and sero-negative autoimmune encephalitis. No side effects were encountered.

Conclusion: To our knowledge, plasmapheresis has only been reported once to treat DRESS syndrome in a pediatric patient. Early recognition and treatment of this syndrome is paramount. We suggest that plasmapheresis is a relatively safe alternative treatment option for resistant cases especially within the context of other autoimmune conditions.

Key words: Plasmapharesis, DRESS syndrome, ceftriaxone, omeprazole, aciclovir, sero-≠‚Äźnegative autoimmune encephalitis, case report


 



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