{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T21:52:54Z","timestamp":1772401974348,"version":"3.50.1"},"reference-count":6,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,7,6]]},"abstract":"<jats:p>Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening adverse drug reaction characterised by generalised skin rash, fever, lymph node enlargement and haematological abnormalities, in addition to multiorgan involvement. However, diagnosis can be challenging, with rare cases presenting as an acute abdomen.<\/jats:p>\n               <jats:p>Its aetiopathogenesis is not fully understood but inefficient drug detoxification, deregulated immune responses, reactivation of host viruses and genetic predisposition appear to be important. Furthermore, it has been recently recognised that antibiotics may act as promoters of DRESS syndrome caused by another drug. We report the case of a 48-year-old man, receiving allopurinol, who developed DRESS syndrome, initially presenting with a cholecystitis-like acute abdomen that was triggered by antibiotics. This report also emphasises the utility of performing patch skin tests to establish drug imputability.<\/jats:p>","DOI":"10.1136\/bcr-2018-226023","type":"journal-article","created":{"date-parts":[[2018,7,24]],"date-time":"2018-07-24T13:28:21Z","timestamp":1532438901000},"page":"bcr-2018-226023","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Allopurinol-induced DRESS syndrome presented as a cholecystitis-like acute abdomen and aggravated by antibiotics"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3442-615X","authenticated-orcid":false,"given":"Mariana","family":"Batista","sequence":"first","affiliation":[{"name":"Department of Dermatology, Hospitais da Universidade de Coimbra, CentroHospitalar e Universit\u00e1rio de Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Carlos","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universit\u00e1rio de Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Paediatric and Adult Liver Transplantation Unit, Hospitais da Universidade de Coimbra, CentroHospitalar e Universit\u00e1rio de Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margarida","family":"Gon\u00e7alo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Centro Hospitalar e Universit\u00e1rio de Coimbra, Hospitais da Universidade de Coimbra, Coimbra, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,7,24]]},"reference":[{"key":"2025082805140019000_2018.jul24_1.bcr-2018-226023.1","first-page":"e1569","article-title":"Allopurinol-induced drug reaction with Eosinophilia and systemic symptoms syndrome: a cause of Acalculous Cholecystitis?","volume":"9","author":"Waseem","year":"2017","journal-title":"Cureus"},{"key":"2025082805140019000_2018.jul24_1.bcr-2018-226023.2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-205577"},{"key":"2025082805140019000_2018.jul24_1.bcr-2018-226023.3","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12389"},{"key":"2025082805140019000_2018.jul24_1.bcr-2018-226023.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2009.01659.x"},{"key":"2025082805140019000_2018.jul24_1.bcr-2018-226023.5","doi-asserted-by":"publisher","DOI":"10.1684\/ejd.2010.0821"},{"key":"2025082805140019000_2018.jul24_1.bcr-2018-226023.6","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1111\/jdv.13796","article-title":"Patch testing - a valuable tool for investigating non-immediate cutaneous adverse drug reactions to antibiotics","volume":"31","author":"Pinho","year":"2017","journal-title":"J Eur Acad Dermatol Venereol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-226023","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:14:07Z","timestamp":1756383247000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-226023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,24]]},"references-count":6,"alternative-id":["10.1136\/bcr-2018-226023"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-226023","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,24]]}}}