Allergy Asthma Respir Dis.  2016 Jul;4(4):296-300. 10.4168/aard.2016.4.4.296.

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

• Song HS
• Choi WH
• Choi WB
• Yang S
• Hwang IT
• Baek HS

• KMID: 2346760
• DOI: http://doi.org/10.4168/aard.2016.4.4.296

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.

Keyword

Drug eruptions; Drug hypersensitivity; Eosinophilia; Acetaminophen

MeSH Terms

Acetaminophen
Child*
Diagnosis
Drug Eruptions
Drug Hypersensitivity
Eosinophilia*
Exanthema
Fever
Humans
Hypersensitivity
Ibuprofen
Leukocytosis
Liver
Male*
Methylprednisolone
Acetaminophen
Ibuprofen
Methylprednisolone

Figure

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  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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