{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T20:09:09Z","timestamp":1768680549339,"version":"3.49.0"},"reference-count":11,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,1,3]]},"abstract":"<jats:p>Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe, potentially life-threatening idiosyncratic drug reaction that may result in skin eruption, mucous membrane involvement, eosinophilia, atypical lymphocytosis and lymphadenopathy, with wide-ranging internal organ involvement. The authors report the case of a 21-year-old man who was prescribed lamotrigine for anxiety disorder. After 2\u2009weeks of treatment, he developed a pruritic morbilliform rash on his trunk and upper extremities that was associated with fever, sore throat, bilateral scleral injection, nausea, vomiting and abdominal pain. A laboratory work-up revealed elevated transaminases and atypical lymphocytosis. He was found to have an active Epstein-Barr virus infection. Lamotrigine was discontinued due to suspicion of DRESS; the patient received pulsed intravenous methylprednisolone followed by oral prednisone taper, which resulted in a significant improvement of symptoms. At follow-up 3\u2009weeks later, signs and symptoms had completely resolved. Follow-up laboratory tests revealed that liver dysfunction had normalised.<\/jats:p>","DOI":"10.1136\/bcr-2017-222416","type":"journal-article","created":{"date-parts":[[2018,1,24]],"date-time":"2018-01-24T06:37:09Z","timestamp":1516775829000},"page":"bcr-2017-222416","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Lamotrigine-induced drug reaction with eosinophilia and systemic symptoms (DRESS) during primary Epstein-Barr virus (EBV) infection"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6605-6088","authenticated-orcid":false,"given":"Ibrahim","family":"Tawhari","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Utah Health, Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fawaz","family":"Tawhari","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Jazan University, Jazan, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mossab","family":"Aljuaid","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Utah Health, Salt Lake City, Utah, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,1,23]]},"reference":[{"key":"2025082804100962000_2018.jan23_1.bcr-2017-222416.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2013.01.033"},{"key":"2025082804100962000_2018.jan23_1.bcr-2017-222416.2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr.02.2011.3898"},{"key":"2025082804100962000_2018.jan23_1.bcr-2017-222416.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1085-5629(96)80038-1"},{"key":"2025082804100962000_2018.jan23_1.bcr-2017-222416.4","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1111\/j.1525-1470.2011.01558.x","article-title":"Drug reaction with eosinophilia and systemic symptoms (DRESS) associated with azithromycin in acute Epstein-Barr virus infection","volume":"28","author":"Bauer","year":"2011","journal-title":"Pediatr Dermatol"},{"key":"2025082804100962000_2018.jan23_1.bcr-2017-222416.5","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1111\/j.1525-1470.2009.00891.x","article-title":"Drug-induced hypersensivity syndrome associated with Epstein-Barr virus infection: a pediatric case report","volume":"26","author":"Scagni","year":"2009","journal-title":"Pediatr Dermatol"},{"key":"2025082804100962000_2018.jan23_1.bcr-2017-222416.6","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1097\/01.TP.0000102459.25647.C6","article-title":"Drug-induced hypersensitivity syndrome associated with primary Epstein-Barr virus and human herpesvirus 6 infections in a child intestinal transplant recipient","volume":"77","author":"Mah\u00e9","year":"2004","journal-title":"Transplantation"},{"key":"2025082804100962000_2018.jan23_1.bcr-2017-222416.7","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2003.05330.x"},{"key":"2025082804100962000_2018.jan23_1.bcr-2017-222416.8","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.jmii.2014.06.012","article-title":"Drug reaction with eosinophilia and systemic symptoms during primary Epstein-Barr virus infection","volume":"48","author":"Nanishi","year":"2015","journal-title":"J Microbiol Immunol Infect"},{"key":"2025082804100962000_2018.jan23_1.bcr-2017-222416.9","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3001116"},{"key":"2025082804100962000_2018.jan23_1.bcr-2017-222416.10","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12501"},{"key":"2025082804100962000_2018.jan23_1.bcr-2017-222416.11","first-page":"31","article-title":"Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome","volume":"6","author":"Choudhary","year":"2013","journal-title":"J Clin Aesthet Dermatol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-222416","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:10:21Z","timestamp":1756379421000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-222416"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,23]]},"references-count":11,"alternative-id":["10.1136\/bcr-2017-222416"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-222416","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,1,23]]}}}