{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:05:41Z","timestamp":1754093141951,"version":"3.41.2"},"reference-count":15,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We present a case of sirolimus\u2010induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome in a stem cell transplant patient. Sirolimus is an immunosuppressive drug that inhibits the mammalian target of rapamycin (mTOR) pathway. A 24\u2010year\u2010old male with a history of acute lymphoblastic leukemia (ALL) underwent testicular extraction followed by hematopoietic stem cell transplantation (HSCT). He presented with pruritic eczematous lesions, which were initially treated with topical steroids. However, he later developed diffuse xerosis, fever, chills, generalized edema, weight gain, eosinophilia, and leukopenia. Skin biopsy showed spongiotic dermatitis with eosinophils, suggesting a drug or atopic reaction. Investigations ruled out infections, and the RegiSCAR score indicated drug reaction syndrome with eosinophilia and systemic symptoms (DRESS). Sirolimus, an immunosuppressive drug, was suspected as the cause. Sirolimus was discontinued, and oral steroids were initiated. After 3\u2009weeks of therapy, the patient showed improvement with resolution of symptoms. Although no cases of sirolimus\u2010induced DRESS syndrome have been reported, allergic reactions with eosinophilia induced by everolimus have been documented. In our case, the patient's history characterized by stem cell transplantation and multiple immunosuppressive therapies may have contributed to the development of DRESS syndrome after beginning sirolimus therapy. This case may be the first evidence of sirolimus\u2010induced DRESS syndrome in a stem cell transplant patient.<\/jats:p>","DOI":"10.1002\/ccr3.7829","type":"journal-article","created":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T08:39:27Z","timestamp":1693557567000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["<scp>DRESS<\/scp> syndrome in a patient undergoing stem cell transplantation: Can sirolimus be involved?"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5014-1122","authenticated-orcid":false,"given":"Fortunato","family":"Cassalia","sequence":"first","affiliation":[{"name":"Dermatology Unit Department of Medicine (DIMED) University of Padua  Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Spiller","sequence":"additional","affiliation":[{"name":"Dermatology Unit Department of Medicine (DIMED) University of Padua  Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Salmaso","sequence":"additional","affiliation":[{"name":"Dermatology Unit Department of Medicine (DIMED) University of Padua  Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3583-0816","authenticated-orcid":false,"given":"Francesca","family":"Caroppo","sequence":"additional","affiliation":[{"name":"Dermatology Unit Department of Medicine (DIMED) University of Padua  Padua Italy"},{"name":"Pediatric Dermatology Regional Center Department of Women and Children's Health (SDB) University of Padua  Padua Italy"},{"name":"European Network for Rare Skin Disorders (ERN\u2010Skin)  Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Belloni\u00a0Fortina","sequence":"additional","affiliation":[{"name":"Dermatology Unit Department of Medicine (DIMED) University of Padua  Padua Italy"},{"name":"Pediatric Dermatology Regional Center Department of Women and Children's Health (SDB) University of Padua  Padua Italy"},{"name":"European Network for Rare Skin Disorders (ERN\u2010Skin)  Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms11020346"},{"issue":"2","key":"e_1_2_9_3_1","first-page":"157","article-title":"Dermatologic emergencies","volume":"36","author":"Temiz SA","year":"2020","journal-title":"Selcuk Med J"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/molecules27165295"},{"issue":"12","key":"e_1_2_9_5_1","article-title":"Target of rapamycin inhibitors (TOR\u2010I; sirolimus and everolimus) for primary immunosuppression in kidney transplant recipients","volume":"12","author":"Hahn D","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"issue":"4","key":"e_1_2_9_6_1","first-page":"715","article-title":"S\u00edndrome de hipersensibilidade aos antiepil\u00e9pticos na crian\u00e7a [anticonvulsant hypersensitivity syndrome in children]","volume":"23","author":"Pinheiro AE","year":"2010","journal-title":"Acta Medica Port"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.4067\/S0034-98872020000801213"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.4103\/0253-7613.96351"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-020-03005-9"},{"issue":"4","key":"e_1_2_9_10_1","first-page":"475","article-title":"COVID\u201019 Hastas\u0131nda Geli\u015fen Dress Sendromu Olgusu: Iacute;laca Ba\u011fl\u0131 m\u0131, Hastal\u0131\u011fa Ba\u011fl\u0131 m\u0131?","volume":"40","author":"Ba\u015fer EN","year":"2020","journal-title":"Turk J Med Sci. Tip Bilimleri Dergisi"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12501"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.waojou.2022.100673"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/idoj.idoj_452_21"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.12112"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms17050735"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.26387"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.7829","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T05:56:37Z","timestamp":1754027797000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.7829"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":15,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1002\/ccr3.7829"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.7829","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"type":"print","value":"2050-0904"},{"type":"electronic","value":"2050-0904"}],"subject":[],"published":{"date-parts":[[2023,9]]},"assertion":[{"value":"2023-05-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e7829"}}