Dress syndrome caused by phenobarbital: description of two cases in neurology department at fann national teaching hospital, Dakar

Marième Soda Diop-Sène, Ousmane Cisse, Soumaila Boubacar, El Hadji Makhtar Ba, Ibrahima M Diallo, Patrice Ntenga, Adjaratou Dieynaba Sow, Anna Modji Basse, Ngor Side Diagne, Maouly Fall, Moustapha Ndiaye, Amadou Gallo DIOP, Mouhamadou Mansour Ndiaye

Drug reaction with eosinophilia and systemic symptoms (DRESS) or drug hypersensitivity syndrome, or even drug-induced hypersensitivity syndrome (DIHS) is a rare and often unknown reactions. It has been used for the first time in 1996 by Bocquet and characterised by demonstrations at type of generalized rash of hyperthermia, polyadenopathy, breach united or it’s including a hepatic cytolysis, of hypereosinophilia, of acute renal failure. Here, we report two cases of DRESS syndrome after a traitmeent by Phenobarbital. They are a man aged 26 and a woman of 32 years who are patients known epileptics whose man presented a DRESS Syndrome three weeks after the beginning of Phenobarbital taken while the woman developed her symptomatology after two weeks of taking the treatment. The 26-year-old patient had a hepatocellular insufficiency associated with lung damage. The 32-year-old patient had not other complications but was in an array of severe dehydration. We had carried the biological tests and medical imaging for the assessment of extension. HIV status was negative in our two patients. Two patients after a stop of Phenobarbital benefited each symptomatic treatment and a prescription of sodium valproate. Evolution was marked in the two patients by a sharp decline of the hypereosinophilia and other biological markers. However, a few episodes of generalized seizures were noted following the change of Phenobarbital. Dress syndrome must be discussed in any patient taking phenobarbital and presents cutaneous signs because early treatment is necessary to avoid complications and improves the prognosis.

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