A RARE CASE OF DRESS SYNDROME WITH ATAXIA SECONDARY TO PHENYTOIN

Jyothi A.*, Bhanuchand P.

ABSTRACT

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but characterized by life-threatening reaction to drugs, it is characterized by skin rashes, fever, haematological disturbances, lymphadenopathy and organ failure, most probably hepatic dysfunction[1] The onset of symptoms is often delayed, occurring 2–6 weeks after drug initiation. DRESS syndrome shares many characteristics in common with anticonvulsant hypersensitivity syndrome (AHS), also referred to as drug-induced hypersensitivity syndrome (DIHS) and appears to represent a variation in presentation rather than a distinctly different syndrome. The incidence of DRESS has been estimated to be between 1 in 1,000 and 1 in 10,000 drug exposures. It carries a mortality rate of 10–20%, with most fatalities the result of liver failure. Treatment consists of supportive therapy, corticosteroids and antihistamines.[2-4] Here we report a case of this syndrome presenting with fever, generalised pruritus, macular rash cholestatic hepatitis and ataxia following treatment with Phenytoin. Conculsion: DRESS even though life threatening can be treated with prompt withdrawal of the offending drug and corticosteroids.

Keywords: Rash, Fever, Liver, Phenytoin, DRESS.