Hemodialysis treatment of vancomycin-induced drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome in a patient undergoing peritoneal dialysis
© 2024. The Author(s), under exclusive licence to Japanese Society of Nephrology..
Drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug-induced hypersensitivity syndrome (DIHS), is a severe drug-induced hypersensitivity reaction with 10% mortality. To date, there is insufficient evidence regarding the association between DRESS/DIHS and serum levels of vancomycin (VCM). Here, we report the case of a 46-year-old woman undergoing peritoneal dialysis who developed VCM-induced DRESS/DIHS. She was hospitalized for peritonitis with abdominal pain and treated with VCM. On day 10 of hospitalization, her abdominal symptoms improved; however, fever, skin rash, lymphadenopathy, eosinophilia, atypical lymphocytes, and liver and renal dysfunction developed. Based on the clinical course and laboratory findings, we diagnosed the patient with DRESS/DIHS due to VCM. Since her serum VCM concentration was high at 39.8 μg/mL, hemodialysis (HD) was performed to remove VCM, which caused her symptoms to improve. However, serum levels of VCM rebounded and the same symptoms recurred. Therefore, we re-performed HD; no further relapse occurred. This clinical course showed that increased serum VCM levels were associated with DRESS/DIHS onset and severity, suggesting that it is a blood level-dependent disease and that removal of VCM by HD is a potential therapeutic option.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
CEN case reports - (2024) vom: 10. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Mitsuno, Ryunosuke [VerfasserIn] |
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| Links: |
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| Themen: |
Dialysis |
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| Anmerkungen: |
Date Revised 10.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1007/s13730-023-00847-x |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368265986 |
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| 245 | 1 | 0 | |a Hemodialysis treatment of vancomycin-induced drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome in a patient undergoing peritoneal dialysis |
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| 520 | |a © 2024. The Author(s), under exclusive licence to Japanese Society of Nephrology. | ||
| 520 | |a Drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug-induced hypersensitivity syndrome (DIHS), is a severe drug-induced hypersensitivity reaction with 10% mortality. To date, there is insufficient evidence regarding the association between DRESS/DIHS and serum levels of vancomycin (VCM). Here, we report the case of a 46-year-old woman undergoing peritoneal dialysis who developed VCM-induced DRESS/DIHS. She was hospitalized for peritonitis with abdominal pain and treated with VCM. On day 10 of hospitalization, her abdominal symptoms improved; however, fever, skin rash, lymphadenopathy, eosinophilia, atypical lymphocytes, and liver and renal dysfunction developed. Based on the clinical course and laboratory findings, we diagnosed the patient with DRESS/DIHS due to VCM. Since her serum VCM concentration was high at 39.8 μg/mL, hemodialysis (HD) was performed to remove VCM, which caused her symptoms to improve. However, serum levels of VCM rebounded and the same symptoms recurred. Therefore, we re-performed HD; no further relapse occurred. This clinical course showed that increased serum VCM levels were associated with DRESS/DIHS onset and severity, suggesting that it is a blood level-dependent disease and that removal of VCM by HD is a potential therapeutic option | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Dialysis | |
| 650 | 4 | |a Drug reaction with eosinophilia and systemic symptoms | |
| 650 | 4 | |a Drug-induced hypersensitivity syndrome | |
| 650 | 4 | |a Vancomycin | |
| 700 | 1 | |a Nakayama, Takashin |e verfasserin |4 aut | |
| 700 | 1 | |a Uchiyama, Kiyotaka |e verfasserin |4 aut | |
| 700 | 1 | |a Yoshimoto, Norifumi |e verfasserin |4 aut | |
| 700 | 1 | |a Kusahana, Ei |e verfasserin |4 aut | |
| 700 | 1 | |a Morimoto, Kohkichi |e verfasserin |4 aut | |
| 700 | 1 | |a Yoshino, Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Yoshida, Tadashi |e verfasserin |4 aut | |
| 700 | 1 | |a Kanda, Takeshi |e verfasserin |4 aut | |
| 700 | 1 | |a Yamaguchi, Shintaro |e verfasserin |4 aut | |
| 700 | 1 | |a Hayashi, Kaori |e verfasserin |4 aut | |
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