DRESS syndrome with carbamazepine and Epstein–Barr virus reactivation

Abstract

DRESS syndrome is a serious toxidermia, most often caused by anticonvulsants, including carbamazepine, which is responsible for a formidable clinical picture and which may be accompanied by viral reactivations, in particular of the herpes group. Herein, we report the case of a young girl affected by DRESS syndrome with the reactivation of EBV, in whom the evolution was favorable. Recurrent EBV infection is demonstrated by the presence of IgM antibodies to anti-EBV early antigen and IgG antibodies to anti-EBV nuclear antigen. Its pathogenesis suggests that viral reactivation is the consequence of a T-immune response directed against the causative drug in some patients. It is an unpredictable entity requiring immediate treatment, namely stopping the drug in question, monitoring the patient, searching for viral reactivation and notifying pharmacovigilance. Key words: Dress syndrom; carbamazepine; EBV; rash; reactivation