Apixaban
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DRESS syndrome: case report A 69-year-old woman developed drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome during treatment with apixaban for atrial fibrillation. The woman was admitted with a generalised maculopapular rash, facial oedema and fever. It was reported that she had a history of atrial fibrillation and had been receiving treatment with oral apixaban 5mg twice daily for 6 weeks. Dermatological examination revealed severe midfacial oedema and widespread erythematous macules, plaques and papules on the trunk. Peripheral blood tests revealed anaemia and increased levels of C-reactive protein, serum creatinine, blood urea nitrogen, SGOT, SGPT, ALP and GGT. Abdominopelvic ultrasound showed mild hepatosplenomegaly. A skin biopsy from the eruptions revealed vasculopathy with interface dermatitis. Registry of severe cutaneous adverse reaction (RegiSCAR) criteria showed a score of six. Based on these findings and clinical presentation, a definite diagnosis of DRESS syndrome was made [duration of treatment to reaction onset not stated]. The woman’s treatment with apixaban was discontinued. Subsequently, she was treated with heparin [unfractionated heparin], cetirizine, prednisolone and methylprednisolone aceponate. Following 15 days of treatment, her symptoms resolved, and laboratory examinations were normal. Mentesoglu D, et al. Drug reaction with eosinophilia and systemic symptoms syndrome induced by apixaban. Dermatologic Therapy 33: No. 4, Jul-Aug 2020. Available from: 803505113 URL: http://doi.org/10.1111/dth.13719
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Reactions 3 Oct 2020 No. 1824
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