{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T03:28:38Z","timestamp":1793935718639,"version":"4.8.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"3-4","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy, Immunology, and Pulmonology"],"published-print":{"date-parts":[[2026,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Background:<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe hypersensitivity reaction. While aromatic anticonvulsants are common triggers, valproic acid (VPA), a non-aromatic agent, is rarely implicated. Pulmonary involvement further complicates the prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Case Presentation:<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>A 9-year-old girl with cerebral palsy and epilepsy developed DRESS syndrome 4 weeks after VPA initiation. Clinical features included persistent fever, dyspnea, eosinophilia, and hepatitis. During follow-up, she developed a widespread maculopapular rash, respiratory distress, and pleural effusion requiring chest tube drainage. After excluding infectious and autoimmune etiologies, a diagnosis of \u201cprobable DRESS syndrome according to the RegiSCAR criteria\u201d was made. Following VPA discontinuation and treatment with systemic corticosteroids and intravenous immunoglobulin, the patient recovered and was discharged after 24 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>VPA-induced DRESS syndrome with simultaneous hepatic and pulmonary involvement is exceptionally rare in children. Clinicians should be alert for DRESS syndrome in pediatric patients on antiepileptics presenting with fever, rash, and multi-organ dysfunction to ensure prompt intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2151321x261486686","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:55:06Z","timestamp":1788951306000},"page":"133-138","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A Rare Pediatric Case of Valproic Acid-Induced Dress Syndrome with Concomitant Pulmonary and Hepatic Involvement"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2354-1216","authenticated-orcid":false,"given":"Hilal","family":"Par\u0131ldar Tiryaki","sequence":"first","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Basaksehir Cam and Sakura City Hospital, Istanbul, T\u00fcrkiye."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Sert","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Basaksehir Cam and Sakura City Hospital, Istanbul, T\u00fcrkiye."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meryem","family":"\u00d6z\u00e7elik","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Basaksehir Cam and Sakura City Hospital, Istanbul, T\u00fcrkiye."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meryem Bet\u00fcl","family":"Demir","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Basaksehir Cam and Sakura City Hospital, Istanbul, T\u00fcrkiye."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cansu","family":"Badem Kaya","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, \u00c7erkezk\u00f6y State Hospital, Tekirda\u011f, T\u00fcrkiye."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c7i\u011fdem","family":"Aydo\u011fmu\u015f","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Basaksehir Cam and Sakura City Hospital, Istanbul, T\u00fcrkiye."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u0131nar","family":"G\u00f6kmirza","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Basaksehir Cam and Sakura City Hospital, Istanbul, T\u00fcrkiye."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/pai.70103"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/7863815"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12144576"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10184287"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1108345"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.waojou.2022.100673"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11030704"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-024-08983-7"},{"issue":"9","key":"e_1_3_2_10_1","first-page":"e17860","article-title":"Non-aromatic anticonvulsant (divalproex sodium)-induced Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome","volume":"13","author":"Dutta P","year":"2021","unstructured":"9.Dutta P, , Das S, , Fershko A. 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Valproic acid-induced DRESS in a child responding to cyclosporine with HLA analysis. 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