4.2 Article

DRESS-syndrome on sulfasalazine and naproxen treatment for juvenile idiopathic arthritis and reactivation of human herpevirus 6 in an 11-year-old caucasian boy

Journal

JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS
Volume 35, Issue 3, Pages 365-370

Publisher

WILEY-BLACKWELL
DOI: 10.1111/j.1365-2710.2009.01081.x

Keywords

children; DRESS-syndrome; human herpevirus 6; juvenile idiopathic arthritis; sulfasalazine-naproxen

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P>DRESS-syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) is a severe drug-induced hypersensitivity syndrome characterized by diffuse maculopapular rash, lymphadenopathy, multivisceral involvement, eosinophilia and atypical lymphocytes with a mortality rate of 10-40% (Seminars in Cutaneous Medicine and Surgery, 1, 250). It is described in adults treated with aromatic antiepileptics and less frequently with sulphonamides, and non-steroidal anti-inflammatory drugs (Clinics in Dermatology, 23, 171; Pediatrics, 108, 485). We report on an 11-year-old Caucasian boy hospitalized with a skin eruption, lymphadenopathy, acute hepatitis, renal tubular involvement, haematological abnormalities and human-herpevirus-6 reactivation, treated with sulfasalazine and naproxen for juvenile idiopathic arthritis (JIA). This is the first report in children with rheumatic disease and highlights the possibility of sulfasalazine and naproxen-induced-DRESS-syndrome in children with JIA.

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