Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Induced by Imatinib

• Published in: Current drug safety Vol. 14; no. 2; p. 151
• Main Authors: Zgolli, F, Aouinti, I, Charfi, O, Badri, T, Elaidli, S, Kastalli, S, Lakhoua, G, Zaïem, A
• Format: Journal Article
• Language: English
• Published: United Arab Emirates 01-01-2019
• Subjects: Antineoplastic Agents - adverse effects; Eosinophilia - etiology; Exanthema - etiology; Female; Humans; Imatinib Mesylate - adverse effects; Middle Aged; Drug hypersensitivity syndrome; GIST; CML; pharmacovigilance; DRESS syndrome imatinib; adverse drug reaction
• ISSN: 2212-3911
• DOI: 10.2174/1574886314666190130150243

Imatinib is the treatment of choice in patients with locally advanced or metastatic gastrointestinal stromal tumours (GIST). Clinical tolerance of imatinib is excellent except for the common adverse drug reaction (ADR). Drug rash with eosinophilia and systemic symptoms (DRESS syndrome) is a severe, potentially life-threatening drug-induced hypersensitivity reaction, characterized by cutaneous eruptions, fever, diffuse lymphadenopathy, along with eosinophilia, and elevated liver function tests. This ADR is rarely reported with imatinib. Only four cases of DRESS syndrome associated with imatinib have already been published.
We report an exceptional case of DRESS syndrome associated with imatinib in a 46 year-old woman with GIST. Two weeks after she had started imatinib therapy, she developed a skin rash, with eosinophilia and elevated liver tests. Plasma level of imatinib was within the therapeutic range. Imatinib was immediately discontinued. A favourable outcome was slowly observed after the drug had been stopped.
This case was scored three according to the European Registry of Severe Cutaneous Adverse Reactions Study Group (RegiSCAR). The Naranjo score for imatinib was five (probable).