Fever with pancytopenia in a patient with lamotrigin induced DRESS syndrome: a case-based review
Authors: Dimitris Kounatidis, Christina Vourlakou, Fotis Panagopoulos, Ioanna Papaodyssea, Eugenia Grivakou, Vasilis Stamatopoulos, Alexandros Skourtis, Natalia Vallianou
Background: Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare idiosyncratic and unpredictable drug reaction most commonly attributed to anticonvulsants, allopurinol, and antibiotics. Fever in combination with cutaneous manifestations and eosinophilia are the cardinal clinical findings, while organ involvement and very rarely pancytopenia can be present. Case presentation: We describe a 26-year-old female patient with pancytopenia in the context of lamotrigine-induced DRESS and we summarize this as a potentially life-threatening hypersensitivity reaction. Conclusion: DRESS should be suspected in patients presenting with fever, eosinophilia, skin involvement, and/or visceral organ involvement, who have started a new drug during the past 2 to 6 weeks, as early recognition of this syndrome with subsequent discontinuation of the offending drug could be lifesaving.
Keywords: DRESS; lamotrigine; hypersensitivity reaction; pancytopenia
Authors
Correspondence to:
Natalia Vallianou, Department of Internal Medicine, Evangelismos General Hospital, Athens, Greece natalia.vallianou@hotmail.com
Publication history:
Received 31 Dec 2021
Accepted 20 Apr 2022
Published online 07 Jul 2022
Published in print 12 Aug 2022
Kounatidis D, Vourlakou C, Panagopoulos F, Papaodyssea I, Grivakou E, Stamatopoulos V, Skourtis A, Vallianou N. Fever with pancytopenia in a patient with lamotrigin induced DRESS syndrome: a case-based review. EJMCR. 2022; 6(4): 64-67. doi:
10.24911/ejmcr/173-1640961455
Kounatidis D, Vourlakou C, Panagopoulos F, Papaodyssea I, Grivakou E, Stamatopoulos V, Skourtis A, Vallianou N. Fever with pancytopenia in a patient with lamotrigin induced DRESS syndrome: a case-based review. https://www.ejmcr.com/?mno=140065 [Access: May 02, 2024]. doi:
10.24911/ejmcr/173-1640961455
Kounatidis D, Vourlakou C, Panagopoulos F, Papaodyssea I, Grivakou E, Stamatopoulos V, Skourtis A, Vallianou N. Fever with pancytopenia in a patient with lamotrigin induced DRESS syndrome: a case-based review. EJMCR. 2022; 6(4): 64-67. doi:
10.24911/ejmcr/173-1640961455
Kounatidis D, Vourlakou C, Panagopoulos F, Papaodyssea I, Grivakou E, Stamatopoulos V, Skourtis A, Vallianou N. Fever with pancytopenia in a patient with lamotrigin induced DRESS syndrome: a case-based review. EJMCR. (2022), [cited May 02, 2024]; 6(4): 64-67. doi:
10.24911/ejmcr/173-1640961455
Kounatidis, D., Vourlakou, . C., Panagopoulos, . F., Papaodyssea, . I., Grivakou, . E., Stamatopoulos, . V., Skourtis, . A. & Vallianou, . N. (2022) Fever with pancytopenia in a patient with lamotrigin induced DRESS syndrome: a case-based review. EJMCR, 6 (4), 64-67. doi:
10.24911/ejmcr/173-1640961455
Kounatidis, Dimitris, Christina Vourlakou, Fotis Panagopoulos, Ioanna Papaodyssea, Eugenia Grivakou, Vasilis Stamatopoulos, Alexandros Skourtis, and Natalia Vallianou. 2022. Fever with pancytopenia in a patient with lamotrigin induced DRESS syndrome: a case-based review. European Journal of Medical Case Reports, 6 (4), 64-67. doi:
10.24911/ejmcr/173-1640961455
Kounatidis, Dimitris, Christina Vourlakou, Fotis Panagopoulos, Ioanna Papaodyssea, Eugenia Grivakou, Vasilis Stamatopoulos, Alexandros Skourtis, and Natalia Vallianou. "Fever with pancytopenia in a patient with lamotrigin induced DRESS syndrome: a case-based review." European Journal of Medical Case Reports 6 (2022), 64-67. doi:
10.24911/ejmcr/173-1640961455
Kounatidis, Dimitris, Christina Vourlakou, Fotis Panagopoulos, Ioanna Papaodyssea, Eugenia Grivakou, Vasilis Stamatopoulos, Alexandros Skourtis, and Natalia Vallianou. "Fever with pancytopenia in a patient with lamotrigin induced DRESS syndrome: a case-based review." European Journal of Medical Case Reports 6.4 (2022), 64-67. Print. doi:
10.24911/ejmcr/173-1640961455
Kounatidis, D., Vourlakou, . C., Panagopoulos, . F., Papaodyssea, . I., Grivakou, . E., Stamatopoulos, . V., Skourtis, . A. & Vallianou, . N. (2022) Fever with pancytopenia in a patient with lamotrigin induced DRESS syndrome: a case-based review. European Journal of Medical Case Reports, 6 (4), 64-67. doi:
10.24911/ejmcr/173-1640961455