Allopurinol-induced DRESS syndrome triggered by COVID-19

Abstract

Drug reaction with eosinophilia and systemic symptoms syndrome (DRESS Syndrome) is caused by many different aetiological factors. We present the case of a 56-year-old woman who started allopurinol treatment about 3 weeks before. She presented with fever, hypotension, tachycardia, generalized maculopapular cutaneous rash, facial edema and axillar, inguinal and cervical enlarged lymph nodes. Complementary diagnostic exams: slight lymphocytosis, eosinophilia, acute renal failure, elevated hepatic enzymes. Swab for SARS-CoV-2 was positive. Serologic tests for another virus were negative. Histopathological analysis was compatible with DRESS syndrome. SARS-CoV-2 could also be taken into account when suspected DRESS syndrome.