A CASE REPORT ON NAVIGATING THE COMPLEXITIES OF PHENYTOIN-INDUCED DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS) SYNDROME

Shikka Mary Mathew*, Jeeva Elizabeth Thomas, Bevan Abraham, Rex K. Roys and Dr. Sunil Antony

ABSTRACT

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe hypersensitivity reaction associated with various medications, including anticonvulsants like phenytoin. We report a case of a 64year old male patient who developed DRESS syndrome following phenytoin therapy for seizure. The patient presented with complains of fever with rashes and itching. He also had an episode of vomiting and gradually progressed to involve multiple organ systems. Laboratory investigations revealed that eosinophils counts were 9% and elevated ESR level. His RFT was deranged with mildly elevated creatinine, which is consistent with a diagnosis of DRESS syndrome. Phenytoin was promptly discontinued and the symptoms were subsided. Our case underscores the importance of recognizing DRESS syndrome as a potential adverse reaction to phenytoin and highlights the challenges associated with its diagnosis and management.

Keywords: DRESS syndrome, drug-induced hypersensitivity syndrome, phenytoin, adverse drug reaction.