{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:23:36Z","timestamp":1787765016422,"version":"build-2784847793"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We present the case of a drug reaction with eosinophilia and systemic symptoms (DRESS) manifesting multi-organ dysfunction syndrome (MODS) that led to death in an elderly patient during the intensive phase of antitubercular therapy (ATT). A 74-year-old male developed skin rash (morbilliform), patchy erythematous macules, pustular\u2013purpuric nonblanching spots, fever, lymphadenopathy, liver dysfunction, leukocytosis, and eosinophilia during intensive phase of ATT (ATT: day 45). Laboratory tests revealed hypereosinophilia (eosinophils; 10500\/\u03bcL), hyperacute fulminant hepatic failure (aspartate transaminase\/alanine transaminase; 1444\/1375 IU\/L, total bilirubin; 11.3 mg\/dL), hepatic encephalopathy (Child\u2013Pugh score: 15), coagulopathy (international normalized ratio; 3.0 and activated partial thromboplastin time; 52 s), and acute renal failure (serum creatinine; 2.6 mg\/dL). The patient was diagnosed with DRESS with a RegiSCAR score of 7 (definite). ATT was discontinued. Despite immediate treatment with pulse methylprednisolone, N-acetylcysteine and sustained low-efficiency dialysis, the patient\u2019s clinical condition evolved to shock due to MODS (sequential organ failure Assessment: 15 points), and on day 51, he succumbed. Concluding, an elderly patient with high-dose antitubercular drugs needs a clinical management review. Clinical symptoms pertaining to DRESS may paradoxically worsen after 3\u20134 days of discontinuation of the offending drug.<\/jats:p>","DOI":"10.4103\/ijmy.ijmy_8_23","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T02:00:50Z","timestamp":1741140050000},"page":"360-363","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Antitubercular Therapy Causing Drug Reaction with Eosinophilia and Systemic Symptoms Manifesting Multi-organ Dysfunction Syndrome and Death in an Elderly Patient: A Case Report with Review of Literature"],"prefix":"10.4103","volume":"12","author":[{"given":"Bijoy Kumar","family":"Panda","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice, Krishna Institute of Pharmacy, Krishna Vishwa Vidyapeeth (Deemed to be University), Satara, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8334-4025","authenticated-orcid":false,"given":"Vaibhav Rajendra","family":"Suryawanshi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Poona College of Pharmacy, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asawari","family":"Raut","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Poona College of Pharmacy, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samrudhi","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Poona College of Pharmacy, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharat","family":"Purandare","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"key":"R1-20250306","doi-asserted-by":"crossref","first-page":"271","DOI":"10.4103\/0975-2870.177688","article-title":"Anti-tuberculosis treatment-induced drug rash with eosinophilia and systemic symptoms syndrome","volume":"9","author":"Bartakke","year":"2016","journal-title":"Med J Dr DY Patil Univ"},{"key":"R2-20250306","doi-asserted-by":"crossref","first-page":"249","DOI":"10.2174\/1574886314666190307150757","article-title":"Drug reaction with eosinophilia and systemic symptoms syndrome associated with ethambutol use:A case report","volume":"14","author":"Kapur","year":"2019","journal-title":"Curr Drug Saf"},{"key":"R3-20250306","doi-asserted-by":"crossref","first-page":"414","DOI":"10.4997\/jrcpe.2020.414","article-title":"Anti-tubercular therapy causing drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome","volume":"50","author":"Saxena","year":"2020","journal-title":"J R Coll Physicians Edinb"},{"key":"R4-20250306","doi-asserted-by":"crossref","first-page":"1","DOI":"10.22270\/jddt.v11i5-S.5060","article-title":"ATT-therapy induced DRESS:A case report","volume":"11","author":"Stanly","year":"2021","journal-title":"J Drug Deliv Ther"},{"key":"R5-20250306","first-page":"e19223","article-title":"Drug reaction with eosinophilia and systemic symptom (DRESS) following rifampicin treatment:A case report","volume":"13","author":"Shrestha","year":"2021","journal-title":"Cureus"},{"key":"R6-20250306","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1038\/clpt.1981.154","article-title":"Amethod for estimating the probability of adverse drug reactions","volume":"30","author":"Naranjo","year":"1981","journal-title":"Clin Pharmacol Ther"},{"key":"R7-20250306","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1111\/j.1365-2133.2006.07704.x","article-title":"Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms:Does a DRESS syndrome really exist?","volume":"156","author":"Kardaun","year":"2007","journal-title":"Br J Dermatol"},{"key":"R8-20250306","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1111\/j.1365-2133.2007.07807.x","article-title":"The diagnosis of a DRESS syndrome has been sufficiently established on the basis of typical clinical features and viral reactivations","volume":"156","author":"Shiohara","year":"2007","journal-title":"Br J Dermatol"},{"key":"R9-20250306","doi-asserted-by":"crossref","first-page":"3280","DOI":"10.4103\/jfmpc.jfmpc_1031_21","article-title":"DRESS syndrome due to first-line antitubercular therapy \u2013A diagnostic imbroglio!","volume":"11","author":"Patra","year":"2022","journal-title":"J Family Med Prim Care"},{"key":"R10-20250306","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s00228-020-03005-9","article-title":"Antibacterial antibiotic-induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome:A literature review","volume":"77","author":"Sharifzadeh","year":"2021","journal-title":"Eur J Clin Pharmacol"},{"key":"R11-20250306","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1046\/j.1365-2125.2003.02007.x","article-title":"Age-related changes in pharmacokinetics and pharmacodynamics:Basic principles and practical applications","volume":"57","author":"Mangoni","year":"2004","journal-title":"Br J Clin Pharmacol"}],"container-title":["The International Journal of Mycobacteriology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijmy.ijmy_8_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:55:16Z","timestamp":1787763316000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijmy.ijmy_8_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":11,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/ijmy.ijmy_8_23","relation":{},"ISSN":["2212-5531","2212-554X"],"issn-type":[{"value":"2212-5531","type":"print"},{"value":"2212-554X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7]]},"assertion":[{"value":"2023-05-10","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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