DRESS SYNDROME

TOPIC: Allergy and Airway TYPE: Global Case Reports INTRODUCTION: Severe cutaneous adverse reactions (SCARs) are a group of disorders caused by drug-induced hypersensitivity response. One important type SCAR is Drug Reaction with Eosinophilia Systemic Symptoms (DRESS) – complex, multisystem, possibly life-threatening drug Here we report case Lamictal associated DRESS which rare seldom reported. CASE PRESENTATION: A 44-year-old Caucasian female past medical history significant for COPD on 3 liters home oxygen, bipolar disorder, recurrent mucocutaneous infections seizures. She has been treatment Patient over last 2 years was admitted in hospital about 5 times episodes cough, wheezing sob. she also had abcesses. Her physician exam consistent middle aged female, diffuse skin lesions. historical chest x-ray shown ongoing lll infiltrates, so it confirmed cat scan showing GGO infiltrates more left lower lobe. investigated pneumonitis panel, fungal serology, strep, legionella antigen negative. slightly IGG level. kept having these inspire optimal therapy . Only notable abnormal findings her laboratory elevated eosinophils count, normal IGE initial count 19% sputum eosinophils. AS diagnosis exclusion syndrome- lamictal diagnosed, quite discontinued switched to alternative anti seizure therapy. Follow up months dropping 3% no symptoms. DISCUSSION: Several mechanisms implicated as part the pathogenesis underlying syndrome:. Most commonly classified IV delayed reaction. Organ involvement due eosinophil infiltration tissue causing damage. Liver commonest organ affected followed kidney then lungs. Lung can present symptoms dyspnea, and/or pleuritic pain, pneumonia, interstitial pneumonitis, pulmonary nodules, or even acute respiratory distress syndrome (ARDS) severe cases he European Registry Cutaneous Adverse Reactions (RegiSCAR) an internationally recognized aid provides clear definition criteria diagnosing syndrome. Though there reasonable controversy exist diagnosis. The most step prompt recognition withdrawal offending drug. corticosteroids generally considered mainstay immunosuppressive should be used cautiously. CONCLUSIONS: but included differential patients peripheral eosinophilia medication known culprit it. REFERENCE #1: Cho, Y.-T., C.-W. Yang, C.-Y. Chu, (DRESS): An Interplay among Drugs, Viruses, Immune System. International journal molecular sciences, 2017. 18(6): p. 1243. #2: Bocquet, H., M. Bagot, J.C. Roujeau, Drug-induced pseudolymphoma (Drug Rash Symptoms: DRESS). Semin Cutan Med Surg, 1996. 15(4): 250-7. #3: Taweesedt, P.T., et al., Pulmonary Manifestations Syndrome: Systematic Review. Biomed Res Int, 2019. 2019: 7863815. DISCLOSURES: No relevant relationships Abhijit Raval, source=Web Response disclosure file Dhruv Raval