Successful Treatment of Imatinib-Induced DRESS Syndrome Using Reslizumab without Cessation of Imatinib: A Case Report

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe cutaneous adverse drug reaction; reported cases are sometimes imatinib mesylate induced. The main treatment is the withdrawal of the causative drug, and most cases with imatinib-induced DRESS syndrome required withdrawal of im...

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Autores principales:	Hyerin Park, Gil-Soon Choi, Eun Mi Lee
Formato:	article
Lenguaje:	EN
Publicado:	Karger Publishers 2021
Materias:	drug reaction with eosinophilia and systemic symptoms imatinib mesylate gastrointestinal stromal tumor reslizumab Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/f00268bb9a734b13af317af9ec5c49c2
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spelling	oai:doaj.org-article:f00268bb9a734b13af317af9ec5c49c22021-11-18T11:08:46ZSuccessful Treatment of Imatinib-Induced DRESS Syndrome Using Reslizumab without Cessation of Imatinib: A Case Report1662-657510.1159/000519471https://doaj.org/article/f00268bb9a734b13af317af9ec5c49c22021-10-01T00:00:00Zhttps://www.karger.com/Article/FullText/519471https://doaj.org/toc/1662-6575Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe cutaneous adverse drug reaction; reported cases are sometimes imatinib mesylate induced. The main treatment is the withdrawal of the causative drug, and most cases with imatinib-induced DRESS syndrome required withdrawal of imatinib. However, in such cases involving anticancer drugs, this may compromise cancer treatment. Herein, we report a patient with imatinib-induced DRESS syndrome that was successfully treated with reslizumab while continuing imatinib treatment. A 65-year-old female presented with facial edema and generalized skin rash after being given 400 mg imatinib 2 weeks ago for metastatic gastrointestinal stromal tumor. After stopping imatinib, the clinical symptoms improved. Imatinib desensitization was performed, and it was administered again. However, the clinical symptoms reappeared more severely 2 months after restart of imatinib, and the peripheral absolute eosinophil count increased to 1,690/μL. A diagnosis of imatinib-induced DRESS syndrome was made, based on the Registry of Severe Cutaneous Adverse Reactions (RegiSCAR) criteria. Imatinib desensitization was repeated, but the clinical symptoms reappeared, and the peripheral eosinophilia persisted. We administered reslizumab, an interleukin-5 monoclonal antibody, without cessation of imatinib. The absolute eosinophil count decreased immediately, and the clinical symptoms improved gradually. After 2 weeks, the clinical symptoms reappeared mildly, but after administering reslizumab again, these disappeared completely. Reslizumab can be considered in the management of DRESS syndrome in cases wherein the causative medication needs to be continued.Hyerin ParkGil-Soon ChoiEun Mi LeeKarger Publishersarticledrug reaction with eosinophilia and systemic symptomsimatinib mesylategastrointestinal stromal tumorreslizumabNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCase Reports in Oncology, Vol 14, Iss 3, Pp 1548-1554 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	drug reaction with eosinophilia and systemic symptoms imatinib mesylate gastrointestinal stromal tumor reslizumab Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	drug reaction with eosinophilia and systemic symptoms imatinib mesylate gastrointestinal stromal tumor reslizumab Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Hyerin Park Gil-Soon Choi Eun Mi Lee Successful Treatment of Imatinib-Induced DRESS Syndrome Using Reslizumab without Cessation of Imatinib: A Case Report
description	Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe cutaneous adverse drug reaction; reported cases are sometimes imatinib mesylate induced. The main treatment is the withdrawal of the causative drug, and most cases with imatinib-induced DRESS syndrome required withdrawal of imatinib. However, in such cases involving anticancer drugs, this may compromise cancer treatment. Herein, we report a patient with imatinib-induced DRESS syndrome that was successfully treated with reslizumab while continuing imatinib treatment. A 65-year-old female presented with facial edema and generalized skin rash after being given 400 mg imatinib 2 weeks ago for metastatic gastrointestinal stromal tumor. After stopping imatinib, the clinical symptoms improved. Imatinib desensitization was performed, and it was administered again. However, the clinical symptoms reappeared more severely 2 months after restart of imatinib, and the peripheral absolute eosinophil count increased to 1,690/μL. A diagnosis of imatinib-induced DRESS syndrome was made, based on the Registry of Severe Cutaneous Adverse Reactions (RegiSCAR) criteria. Imatinib desensitization was repeated, but the clinical symptoms reappeared, and the peripheral eosinophilia persisted. We administered reslizumab, an interleukin-5 monoclonal antibody, without cessation of imatinib. The absolute eosinophil count decreased immediately, and the clinical symptoms improved gradually. After 2 weeks, the clinical symptoms reappeared mildly, but after administering reslizumab again, these disappeared completely. Reslizumab can be considered in the management of DRESS syndrome in cases wherein the causative medication needs to be continued.
format	article
author	Hyerin Park Gil-Soon Choi Eun Mi Lee
author_facet	Hyerin Park Gil-Soon Choi Eun Mi Lee
author_sort	Hyerin Park
title	Successful Treatment of Imatinib-Induced DRESS Syndrome Using Reslizumab without Cessation of Imatinib: A Case Report
title_short	Successful Treatment of Imatinib-Induced DRESS Syndrome Using Reslizumab without Cessation of Imatinib: A Case Report
title_full	Successful Treatment of Imatinib-Induced DRESS Syndrome Using Reslizumab without Cessation of Imatinib: A Case Report
title_fullStr	Successful Treatment of Imatinib-Induced DRESS Syndrome Using Reslizumab without Cessation of Imatinib: A Case Report
title_full_unstemmed	Successful Treatment of Imatinib-Induced DRESS Syndrome Using Reslizumab without Cessation of Imatinib: A Case Report
title_sort	successful treatment of imatinib-induced dress syndrome using reslizumab without cessation of imatinib: a case report
publisher	Karger Publishers
publishDate	2021
url	https://doaj.org/article/f00268bb9a734b13af317af9ec5c49c2
work_keys_str_mv	AT hyerinpark successfultreatmentofimatinibinduceddresssyndromeusingreslizumabwithoutcessationofimatinibacasereport AT gilsoonchoi successfultreatmentofimatinibinduceddresssyndromeusingreslizumabwithoutcessationofimatinibacasereport AT eunmilee successfultreatmentofimatinibinduceddresssyndromeusingreslizumabwithoutcessationofimatinibacasereport
_version_	1718420880222060544

Successful Treatment of Imatinib-Induced DRESS Syndrome Using Reslizumab without Cessation of Imatinib: A Case Report

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