AUTHOR=Pope Eliza I. , Au Hosanna , Levy Deborah M. , Verstegen Ruud H. J. 

TITLE=Case report: Drug reaction with eosinophilia and systemic symptoms (DRESS)-induced hemophagocytic disorder

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.1023522

DOI=10.3389/fphar.2022.1023522

ISSN=1663-9812

ABSTRACT=Hemophagocytic disorders are severe and life-threatening conditions that can be genetic in origin (i.e., hemophagocytic lymphohistiocytosis [HLH]), or result from infections (i.e., secondary HLH), rheumatologic disease (i.e., macrophage activation syndrome [MAS]) and less frequently immunodeficiency or metabolic disease. Although rare, drug-induced hemophagocytosis needs to be considered in the work-up as it requires specific management strategies. Most drug-induced hemophagocytic disorders are related to drug reaction with eosinophilia and systemic symptoms (DRESS). We present the case of a 7-year-old girl who initially presented with fever, maculopapular rash, and unilateral lymphadenopathy, who went on to develop hemophagocytosis secondary to DRESS caused by prolonged combination treatment with amoxicillin/clavulanic acid and trimethoprim/sulfamethoxazole. This case illustrates the importance of considering adverse drug reactions in the evaluations of patients with a hemophagocytic process.