Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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DRESS syndrome with acute interstitial nephritis caused by quinolone and non-steroidal anti-inflammatory drugs

퀴놀론과 비스테로이드소염제 투여 후 발생한 급성 간질성 신염이 동반된 DRESS 증후군

  • Kim, Soo Jin (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Nam, Young-Hee (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Juong, Ji Young (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Kim, Eun Young (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Lee, Su Mi (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Son, Young Ki (Department of Internal Medicine, Dong-A University College of Medicine) ;
  • Nam, Hee-Joo (Regional Pharmacovigilance Center, Dong-A University Hospital) ;
  • Kim, Ki-Ho (Department of Dermatology, Dong-A University College of Medicine) ;
  • Lee, Soo-Keol (Department of Internal Medicine, Dong-A University College of Medicine)
  • 김수진 (동아대학교 의과대학 내과학교실) ;
  • 남영희 (동아대학교 의과대학 내과학교실) ;
  • 정지영 (동아대학교 의과대학 내과학교실) ;
  • 김은영 (동아대학교 의과대학 내과학교실) ;
  • 이수미 (동아대학교 의과대학 내과학교실) ;
  • 손영기 (동아대학교 의과대학 내과학교실) ;
  • 남희주 (동아대학교병원 지역의약품안전센터) ;
  • 김기호 (동아대학교 의과대학 피부과학교실) ;
  • 이수걸 (동아대학교 의과대학 내과학교실)
  • Received : 2015.02.17
  • Accepted : 2015.04.07
  • Published : 2016.06.30
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Abstract

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and severe drug-induced hypersensitivity syndrome characterized by hematological abnormalities and multiorgan involvement. Liver involvement is the most common visceral manifestation. However, renal failure has been rarely described. The common culprit drugs are anticonvulsants and allopurinol. We experienced a patient with DRESS syndrome with acute interstitial nephritis caused by concomitant administration of quinolone and non-steroidal anti-inflammatory drugs (NSAIDs). A 41-year-old man presented with a diffuse erythematous rash and fever which developed after administration of quinolone and NSAIDs for a month due to prostatitis. He was diagnosed with DRESS syndrome. Skin rash, fever, eosinophilia, and elevations of liver enzymes improved with conservative treatment and discontinuation of the causative drugs. However, deterioration of his renal function occurred on day 8 of admission. The levels of blood urea nitrogen and serum creatinine increased and oliguria, proteinuria and urinary eosinophils were observed. Ultrasonography showed diffuse renal enlargement. The clinical features were compatible with acute interstitial nephritis. Despite intravenous rehydration and diuretics, renal function did not improve. After hemodialysis, his renal function recovered completely within 2 weeks without administration of systemic corticosteroid.

Keywords

References

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