Abstract

MOREIRA, Ana Sofia; CADINHA, Susana; VIEIRA, Miguel  and  SILVA, José Pedro Moreira da. Probable contrast media related DRESS syndrome. Rev Port Imunoalergologia [online]. 2017, vol.25, n.4, pp.277-282. ISSN 0871-9721.

The designation DRESS - Drug reaction with eosinophilia and systemic symptoms refers to a severe, potentially life-threatening drug hypersensitivity reaction. We describe the case of a 70 years old male with pruritic and exfoliative exanthema, hand edema, eosinophilia (1980/uL) and conjunctival hyperemia. The symptoms began 4 days after restart treatment with phenytoin and 10 days after a computed tomography with contrast media administration. The patient was treated with corticosteroids and presented gradual clinical improvement but, 2 months later, 24 hours after radiologic contrast media administration, there was a reappearance of a widespread exanthema, hand, face and feet edema, fever, eosinophilia and subsequently cervical lymphadenopathy. Skin prick test, intradermal and patch tests with contrast media were positive at 48 hours. Phenytoin patch tests were negative and the lymphocyte transformation test with phenytoin was doubtful. This case report describes a DRESS syndrome probably related with iodinated contrast media administration

Keywords : Iodinated contrast media; phenytoin; DRESS syndrome; drug hypersensitivity.

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