Severe clopidogrel ‐induced DRESS with eosinophilic pneumonia associated with Epstein–Barr virus reactivation

We report a case of severe clopidogrel ‐induced drug reaction with eosinophilia and systemic symptom (DRESS) with concomitant eosinophilic pneumonia associated with reactivation of Epstein–Barr virus (EBV). The patient was treated with systemic corticosteroids and mechanical ventilation management. DRESS can progress to severe respir atory failure, and presence of EBV or herpes virus in the serum or resected lymph node tissue is an important finding for its diagnosis. AbstractDrug reaction with eosinophilia and systemic symptoms (DRESS) is a type of hypersensitivity drug reaction. Here, we report the case of a 78 ‐year‐old man who presented with a rash, fever, dry cough, and swollen parotid glands who had been prescribed clopidogrel for one year. Computed tomography showed consolidation and interlobular septal thickening with enlarged mediastinal lymph nodes. As oxygen therapy was ineffective, the patien t was intubated and bronchoalveolar lavage cellular analysis showed an increase in eosinophils. Clopidogrel was discontinued and the parotid biopsy revealed periductal lymphocytic infiltration. High doses of corticosteroids were administered, and his symptoms improved. However, his symptoms recurred when clopidogrel was restarted. Skin biopsy showed mild lymphocytic infiltration in the upper dermis with vasculitis, and Epstein–Barr virus (EBV) DNA was detected in his blood and lymph node tissue. On the basis of the pathology and disease manifestations, the patient w...
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Case Report Source Type: research