A case of sulphasalazine-induced DRESS syndrome with delayed acute interstitial nephritis
A case of sulphasalazine-induced DRESS syndrome with delayed acute interstitial nephritis
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DOI：
10.1093/ndt/gfp277
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发表时间：
2009-09-01
影响因子：
6.1
通讯作者：
Subra, Jean-Francois
中科院分区：
文献类型：
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作者：
Augusto, Jean-Francois;Sayegh, Johnny;Subra, Jean-Francois
伴有嗜酸性粒细胞增多和全身症状的药疹（DRESS综合征）是一种罕见的重度药物诱导的超敏反应综合征，其特征为血液学异常（嗜酸性粒细胞增多和/或单核细胞增多）和多器官受累。肾衰竭很少被描述。我们报告的情况下，77岁的女性与柳氮磺胺引起的DRESS综合征谁迅速改善皮质类固醇治疗。泼尼松停药后，患者发生肾衰竭，需要进行血液透析。肾活检显示急性肾小管间质性肾炎伴强烈淋巴细胞浸润和肾小管坏死。皮质类固醇治疗2周后，肾功能恢复正常。这是第一例组织学证实的急性肾小管间质性肾炎的柳氮磺胺吡啶诱导的DRESS综合征。
Drug rash with eosinophilia and systemic symptoms (DRESS syndrome) is a rare and severe drug-induced hypersensitivity syndrome characterized by haematological abnormalities (hypereosinophilia and/or mononucleosis) and multiorgan involvement. Renal failure has been rarely described. We report the case of a 77-year-old female with sulphasalazine-induced DRESS syndrome who improved rapidly on corticosteroid treatment. After prednisone withdrawal, the patient developed renal failure that necessitated a session of haemodialysis. A kidney biopsy showed acute tubulointerstitial nephritis with an intense lymphocytic infiltrate and tubular necrosis. Kidney function normalized after a further 2 weeks of corticosteroid treatment. This is the first histologically proven case of acute tubulointerstitial nephritis in the setting of sulphasalazine-induced DRESS syndrome.