Pseudomembranous conjunctivitis in a patient with DRESS syndrome

• Type of Material: Article
• Authors: Young Joo Lee, Korea University Ansan Hospital; Youngsub Eom, Emory University; Seo Yeon Park, Korea University Ansan Hospital; Jung Jin Shin, Korea University Ansan Hospital; Young Choi, Korea University Ansan Hospital; Jong Suk Song, Korea University College of Medicine; Hyo Myung Kim, Korea University College of Medicine
• Language: English
• Date: 2023-02-18
• Publisher: International Journal of Ophthalmology Press
• Publication Version: Final Published Version
• Copyright Statement: International Journal of Ophthalmology Press
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.18240/ijo.2023.02.20
• Title of Journal or Parent Work: International Journal of Ophthalmology
• Volume: 16
• Issue: 2
• Start Page: 309
• End Page: 311
• Keywords: DRESS syndrome
• Research Categories: Health Sciences, Opthamology

Abstract

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a drug reaction featuring high fever, eosinophilia, skin rashes, and multi-organ involvement that may be fatal. Ocular manifestations, including cicatrizing conjunctivitis, corneal infiltration, and anterior uveitis, are rarely reported[1]–[6] but may cause serious complications if untreated. Therefore, it is important to diagnose DRESS syndrome in patients with ocular features promptly with appropriate treatment. This article reports a case diagnosed with DRESS syndrome associated with pseudomembranous conjunctivitis secondary to carfilzomib. A 52-year-old man visited our ophthalmology department complaining of ocular pain, foreign body sensation, and blurred vision in both eyes that had begun two days prior. Ocular symptoms were manifested with a fever over 38°C. Two days after the ocular manifestation, a skin rash started to spread over his whole body (Figure 1). Laboratory findings showed eosinophilia (eosinophils of 12.5%) and elevated liver enzyme levels [aspartate transaminase (AST) 41 IU/L, alkaline phosphatase (ALP) 165 IU/L, and gamma-glutamyl transferase (GGT) 332 IU/L]. Two years prior, he was diagnosed with multiple myeloma and was treated with peripheral blood stem cell transplantation. Recently, the patient suffered a relapse of multiple myeloma and began chemotherapy with carfilzomib three weeks before visiting our clinic. The written informed consent was obtained from the patient to publish a caser report. All research and data collection adhered to the tenets of the Declaration of Helsinki.