{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,12,7]],"date-time":"2024-12-07T00:40:09Z","timestamp":1733532009000,"version":"3.30.1"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Gastroenterol"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Eine 21-j\u00e4hrige Patientin stellte sich mit seit 2 Wochen bestehendem Fieber, Pharyngitis, Lymphadenopathie und generalisiertem Exanthem vor. Allergien seien nicht bekannt, die Familien- und Reiseanamnese ist unauff\u00e4llig. Aufgrund einer Depression wird seit 1,5 Jahren Duloxetin eingenommen, bei bipolarer St\u00f6rung wurde seit 4 Wochen Lamotrigin eingenommen, bei ansteigenden Transaminasen jedoch abgesetzt. Laborchemisch zeigten sich bei Aufnahme eine Eosinophilie (1,327 \/nl), eine Lymphozytose sowie das Bild einer akuten Hepatitis (GOT 428 U\/l, GPT 438 U\/l) mit eingeschr\u00e4nkter Spontangerinnung. Die Entz\u00fcndungsparameter waren erh\u00f6ht. Sonografisch imponierte eine Hepatosplenomegalie mit Aszites. Eine akute virale oder parasit\u00e4re Infektion wurde serologisch ausgeschlossen. Im Hautbiopsat zeigte sich ein perivaskul\u00e4res Entz\u00fcndungsinfiltrat, passend zu einem Hypersensitivit\u00e4tssyndrom. Im Leberbiopsat fanden sich entz\u00fcndliche Infiltrate, vereinbar mit einer medikament\u00f6s-toxisch induzierten Hepatitis. Im Verlauf traten Husten, Dyspnoe und ein Pleuraerguss rechts auf. In Zusammenschau der Befunde und mit Hilfe des RegiSCAR-Scores konnte die Diagnose \u201edrug reaction with eosinophilia and systemic symptoms\u201c (DRESS) gestellt werden. Unter hochdosierter Prednisolontherapie kam es zu einem sukzessiven Abfall der Transaminasen und zur Rekonstitution der Lebersynthese.<\/jats:p><jats:p>Bei Eosinophilie, Lymphadenopathie, akuter Hepatitis und generalisiertem Exanthem stellt DRESS eine seltene, aufgrund des potenziell lebensbedrohlichen Verlaufes jedoch wichtige Differenzialdiagnose dar. Die wichtigste Ma\u00dfnahme ist das sofortige Absetzen der als Ausl\u00f6ser vermuteten Medikation. In schweren F\u00e4llen sollte die Therapie mit hochdosierten systemischen Kortikosteroiden erfolgen.<\/jats:p>","DOI":"10.1055\/a-2300-0620","type":"journal-article","created":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T22:45:25Z","timestamp":1715813125000},"page":"2056-2060","source":"Crossref","is-referenced-by-count":1,"title":["DRESS als seltene Differentialdiagnose bei Eosinophilie, Hautexanthem und akuter Hepatitis"],"prefix":"10.1055","volume":"62","author":[{"given":"Daniela","family":"Prechal","sequence":"additional","affiliation":[{"name":"Medizinische Klinik, Klinikum Konstanz, Konstanz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Arntzen","sequence":"additional","affiliation":[{"name":"Medizinische Klinik, Klinikum Konstanz, Konstanz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lioba","family":"Klaas","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum Freiburg Abteilung Innere Medizin II Gastroenterologie Hepatologie Endokrinologie und Infektiologie, Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maren","family":"Paulmann","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Dermatologie und Venerologie, Dokumentationszentrum schwerer Hautreaktionen (dZh), Universit\u00e4tsklinikum Freiburg, Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maja","family":"Mockenhaupt","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Dermatologie und Venerologie, Dokumentationszentrum schwerer Hautreaktionen (dZh), Universit\u00e4tsklinikum Freiburg, Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Thimme","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinikum Freiburg Abteilung Innere Medizin II Gastroenterologie Hepatologie Endokrinologie und Infektiologie, Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus","family":"Schuchmann","sequence":"additional","affiliation":[{"name":"Medizinische Klinik, Klinikum Konstanz, Konstanz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,5,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms18061243","article-title":"Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): An Interplay among Drugs, Viruses, and Immune System","volume":"18","author":"YT Cho","year":"2017","journal-title":"Int J Mol Sci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1111\/bjd.12501","article-title":"Drug reaction with eosinophilia and systemic symptoms (DRESS): an original multisystem adverse drug reaction. 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