Drug reaction with eosinophilia and systemic symptom induced in a 9-year-old boy

Han Sol Song; Woo Hyeok Choi; Won-Bok Choi; Seung Yang; Il-Tae Hwang; Hey-Sung Baek

doi:10.4168/aard.2016.4.4.296

Journal List > Allergy Asthma Respir Dis > v.4(4) > 1059197

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Song, Choi, Choi, Yang, Hwang, and Baek: Drug reaction with eosinophilia and systemic symptom induced in a 9-year-old boy

Case Report

Allergy, Asthma & Respiratory Disease 2016; 4(4): 296-300.

Published online: 31 July 2016

DOI: https://doi.org/10.4168/aard.2016.4.4.296

Drug reaction with eosinophilia and systemic symptom induced in a 9-year-old boy

Han Sol Song, Woo Hyeok Choi, Won-Bok Choi, Seung Yang, Il-Tae Hwang, Hey-Sung Baek

Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.

Correspondence to: Hey-Sung Baek. Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, 150 Seongan-ro, Gangdong-gu, Seoul 05355, Korea. Tel: +82-2-2224-2251, Fax: +82-2-482-8334, paviola7@hanmail.net

Received 5 September 2015 Revised 13 October 2015 Accepted 19 October 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/).

Abstract

The drug reaction with eosinophilia and systemic symptom (DRESS) is a severe adverse drug-induced reaction. Acetaminophen is extensively used as an over-the-counter drug as well as a medical therapeutic. In spite of its frequent use, drug eruptions related to DRESS caused by acetaminophen are rare. This case report describes a 9-year-old boy who experienced fever and maculopapular skin rashes after taking acetaminophen. Leukocytosis with marked eosinophilia and slightly elevated levels of liver enzymes were observed. Symptoms resolved after withdrawal of acetaminophen, followed by intravenous methylprednisolone administration. The diagnosis of DRESS induced by acetaminophen was confirmed by an oral challenge test after 2 months. No allergic reactions to ibuprofen were observed.

Keywords: Drug eruptions, Drug hypersensitivity, Eosinophilia, Acetaminophen

Figures and Tables

Fig. 1

Maculopapular rash on neck, back (A), chest, abdomen (B), and extremities (C) at the initial visit.

Fig. 2

Eosinophil count during the course of initial admission (A) and during acetaminophen challenge test (B).

Fig. 3

Maculopapular rash on abdomen (A), and extremities (B) that appeared 12 hours after the start of acetaminophen oral challenge test.

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ORCID iDs: Hey-Sung Baek
https://orcid.org/http://orcid.org/0000-0003-0297-9446
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