Acute Liver Injury in the setting of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome with Cocaine as suspected culprit agent: A case report

Clin Res Hepatol Gastroenterol. 2022 Nov;46(9):102023. doi: 10.1016/j.clinre.2022.102023. Epub 2022 Sep 17.

Abstract

Drug Reaction with Eosinophilia and Systemic Response (DRESS) syndrome is a rare hypersensitivity reaction characterized by rash, fever, lymphadenopathy, and visceral involvement. The liver is frequently involved in DRESS, with increased liver enzymes and hepatomegaly. Over 40 drugs have been implicated in the induction of DRESS, however other illicit substances have also been linked to this. Prompt identification of this syndrome is imperative for management. We report the case of patient presenting with acute liver injury and eosinophilia, who developed a rash meeting criterion for DRESS, with Cocaine as the suspected culprit agent, and was successfully treated with conservative measures.

Keywords: Acute liver injury; Cocaine; Drug reaction with eosinophilia and systemic symptoms syndrome; Eosinophilia.

Publication types

  • Case Reports

MeSH terms

  • Cocaine* / adverse effects
  • Drug Hypersensitivity Syndrome* / diagnosis
  • Drug Hypersensitivity Syndrome* / etiology
  • Drug Hypersensitivity Syndrome* / therapy
  • Eosinophilia* / complications
  • Exanthema* / complications
  • Humans
  • Liver

Substances

  • Cocaine