{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T18:32:04Z","timestamp":1775327524146,"version":"3.50.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Emerg Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe hypersensitivity reaction characterized by cutaneous rash, lymphadenopathy, fever, eosinophilia, leukocytosis, and life-threatening organ dysfunctions. We describe the case of a 26 year old patient admitted to the Emergency Department for DRESS syndrome after sulfasalazine treatment for rheumatoid arthritis in the right knee. Whole body computer tomography showed multiple neck, chest, and abdominal lymphadenopathy with splenomegaly, massive ascites and severe hepatic cytolysis. Serology results for Epstein-Barr Virus (EBV), influenza, measles, rubella, hepatitis A and B were negative. The histologic analysis of skin, lymph node and bone marrow biopsies could not indicate a classical Hodgkin\u2019s Disease or iatrogenic immunodeficiency\/EBV-associated lymphoproliferative disorder (LPD), Hodgkin type. The relatively small caliber of the CD30\u2009+\u2009immunoreactive blastoid cells in the lymph nodes suggested reactive immunoblasts rather than Hodgkin cells. The morphologic aspects of the lymph node biopsies with predominance of T-cells were compatible with the diagnosis of a sulfasalazine-induced DRESS syndrome as the patient had a high RegiSCAR score for DRESS. [DRESS Syndrome Foundation: Diagnosis and Treatment. (2023)] The patient\u2019s complex clinical course, marked by two hospital admissions, highlights the challenges in diagnosing and managing DRESS. This case underscores the need for individualized care, close patient monitoring, and further research to better understand DRESS\u2019s underlying mechanisms and optimal therapeutic strategies.<\/jats:p>","DOI":"10.1186\/s12245-024-00665-7","type":"journal-article","created":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T04:01:52Z","timestamp":1721275312000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A diagnostic dilemma: distinguishing a sulfasalazine induced DRESS hypersensitivity syndrome from a CD30\u2009+\u2009lymphoma in a young patient"],"prefix":"10.1186","volume":"17","author":[{"given":"Natalija","family":"Aleksandrova","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas","family":"De Rop","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederic","family":"Camu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ives","family":"Hubloue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katleen","family":"Devue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,18]]},"reference":[{"key":"665_CR1","unstructured":"DRESS Syndrome Foundation: Diagnosis and Treatment. 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Br J Dermatol. 2013;169(5):1071\u201380.","journal-title":"Br J Dermatol"},{"key":"665_CR6","doi-asserted-by":"crossref","unstructured":"Palma-Grisi D, James C, Vijayagopal K, Muslimani MA. (2019). Case reports of DRESS syndrome and symptoms consistent with DRESS syndrome following treatment with recently marketed monoclonal antibodies. Autoimmune Diseases, 2019.","DOI":"10.1155\/2019\/7595706"},{"issue":"6","key":"665_CR7","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.3390\/ijms18061243","volume":"18","author":"Y-T Cho","year":"2017","unstructured":"Cho Y-T, Yang C-W, Chu C-Y. Drug reaction with eosinophilia and systemic symptoms (DRESS): an interplay among drugs, viruses, and immune system. Int J Mol Sci. 2017;18(6):1243.","journal-title":"Int J Mol Sci"},{"key":"665_CR8","doi-asserted-by":"crossref","unstructured":"Bocquet H, Bagot M, Roujeau JC. (1996). 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The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and to use the images and other clinical information to be reported in the case report.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"94"}}