Hypersensitivity Reactions and Acute Hepatitis Induced by Therapeutic Doses of Ibuprofen

Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) is a severe adverse drug-induced reaction. Diagnosing DRESS is specifically complicated due to the multiplicity of organs involved. The main culprit drugs are carbamazepine and allopurinol, even though almost 50 drugs have been described to have caused this syndrome. We describe a case of a 34-year old woman admitted to our hospital with acute diffuse, pruritic rash associated with cramp abdominal pain, and fever seven days after starting non-steroidal anti-inflammatory drugs (ibuprofen). Investigation revealed leukocytosis, eosinophilia, and elevated serum transaminases. The diagnosis of DREES syndrome was made, ibuprofen was stopped, and systemic corticotherapy was prescribed with gradually improvement of the rash and symptoms resolution. The patient was discharged home after three weeks of hospitalization.