Mehdi Gaha1,2, David Landry3,4, Manon Bélair3,4, Brenda Paquet5,4, Hugo Chapdelaine5,4, Céline Bard3,4. 1. Department of Neuroradiology, Montreal University Hospital (CHUM), Montreal, Canada. mehdi.gaha@yahoo.fr. 2. Department of Radiology, Sahloul University Hospital, Sousse, Tunisia. mehdi.gaha@yahoo.fr. 3. Department of Neuroradiology, Montreal University Hospital (CHUM), Montreal, Canada. 4. Notre-Dame Hospital CHUM, 1560 Sherbrooke East Street, Montreal, Quebec, H2L 4M1, Canada. 5. Department of Immunology, Montreal University Hospital (CHUM), Montreal, Canada.
Abstract
INTRODUCTION: DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome is a severe adverse drug-induced reaction. It manifests with pyrexia, eosinophilia, and lymphadenopathy, with multiple organ involvement, mainly the skin, liver, and kidneys. The purpose of this article is to demonstrate that DRESS syndrome can be associated with cerebral manifestations, a concept not well known in the neuroradiological literature. METHODS: We describe three cases of DRESS syndrome associated with cerebral vasculitic-like lesions and realize a review of the literature to demonstrate that this association represents a very rare entity. RESULTS: Acute ischemic lesions were found among two patients. In all cases, perivascular enhancement was present. Magnetic resonance angiography (MRA) sequence was normal. Although no cerebral biopsy was performed, this enhancement pattern is strongly suggestive of a vasculitic process associated with DRESS syndrome. CONCLUSION: Diagnosis of cerebral vasculitic-like associated lesions must be considered in patients with DRESS syndrome since it can be reversed completely by withdrawing the causal medication and instigating corticosteroid treatment in a timely fashion.
INTRODUCTION: DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome is a severe adverse drug-induced reaction. It manifests with pyrexia, eosinophilia, and lymphadenopathy, with multiple organ involvement, mainly the skin, liver, and kidneys. The purpose of this article is to demonstrate that DRESS syndrome can be associated with cerebral manifestations, a concept not well known in the neuroradiological literature. METHODS: We describe three cases of DRESS syndrome associated with cerebral vasculitic-like lesions and realize a review of the literature to demonstrate that this association represents a very rare entity. RESULTS: Acute ischemic lesions were found among two patients. In all cases, perivascular enhancement was present. Magnetic resonance angiography (MRA) sequence was normal. Although no cerebral biopsy was performed, this enhancement pattern is strongly suggestive of a vasculitic process associated with DRESS syndrome. CONCLUSION: Diagnosis of cerebral vasculitic-like associated lesions must be considered in patients with DRESS syndrome since it can be reversed completely by withdrawing the causal medication and instigating corticosteroid treatment in a timely fashion.
Authors: Daniel M Mandell; Charles C Matouk; Richard I Farb; Timo Krings; Ronit Agid; Karel terBrugge; Robert A Willinsky; Richard H Swartz; Frank L Silver; David J Mikulis Journal: Stroke Date: 2011-12-08 Impact factor: 7.914
Authors: Patrice Cacoub; Philippe Musette; Vincent Descamps; Olivier Meyer; Chris Speirs; Laetitia Finzi; Jean Claude Roujeau Journal: Am J Med Date: 2011-05-17 Impact factor: 4.965