ArticleCureus2021
Non-aromatic Anticonvulsant (Divalproex Sodium)-Induced Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome.
Article in Cureus, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
3 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A wide array of commonly prescribed antiepileptic medications, antibiotics, antivirals, anti-parasitic, and antihyperuricemic can cause Drug Reaction Eosinophilia and Systemic Syndrome (DRESS)- a drug induced hypersensitivity reaction characterized by cutaneous manifestation, fever, eosinophilia, thrombocytopenia and one or more visceral organ involvement. The rare occurrence in clinical settings and wide variety of clinical presentations make DRESS a diagnostically challenging case. A vast majority of DRESS cases are attributed to the most commonly prescribed anticonvulsant medications - phenytoin and carbamazepines. Even though non-aromatic divalproex sodium/valproic acid (VPA) can cause life-threatening fatal hypersensitivity reactions on rare occasions, a handful cases of valproate-induced DRESS have been reported. We hereby report a case of a 57-year-old cognitively impaired person with polypharmacy who presented with worsening diffuse skin rash, fever, dysphagia, eosinophilia, thrombocytopenia, and mixed type of hepatic injury. The patient was eventually diagnosed with DRESS due to divalproex sodium- an anticonvulsant medication. The objective of our report is to identify and recognize the rare yet proper causative agent that induces DRESS and potential mitigation of significant systemic consequences by its subsequent withdrawal.
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