Reactions 1463, p5 - 3 Aug 2013

SAcenocoumarol

DRESS syndrome in an elderly patient: case reportAn 85-year-old man developed DRESS syndrome while

receiving acenocoumarol for thromboembolism prophylaxis.The man was started on acenocoumarol [route and dosage

not stated] for prevention of venous thromboembolism due toatrial fibrillation. He presented at an emergency department6 weeks later, experiencing syncope and exertional dyspnoea.A maculopapular rash was noted on his limbs and trunk, inaddition to purple blisters and lesions on the distal region ofhis legs. Blood tests showed the following values: creatinine1.95 mg/dL, urea 61 mg/dL, GGT 142 UI/L, and eosinophilia of14.20%. The man was suspected to have experienced anadverse reaction to acenocoumarol, and the drug waswithdrawn. He was admitted to hospital, and given systemiccorticosteroids, antihistamines, fluid therapy, enoxaparinsodium and local wound healing. His skin lesions resolved,and he made a good clinical recovery. His abnormal laboratoryvalues were normalising 1 month later. His clinicalmanifestations had completely resolved 45 days later. Skinpatch tests were negative to dabigatran and warfarin, and hewas subsequently commenced on dabigatran forthromboembolism prophylaxis.

Author comment: "We report the case of an 85-year-oldman with [a] diagnosis of DRESS syndrome induced byacenocoumarol".Pinero-Saavedra M, et al. DRESS syndrome induced by acenocoumarol withtolerance to warfarin and dabigatran: A case report. Blood Coagulation andFibrinolysis 24: 576-578, No. 5, 2013. Available from: URL: http://dx.doi.org/10.1097/MBC.0b013e32835facc8 - Spain 803090672

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Reactions 3 Aug 2013 No. 14630114-9954/13/1463-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved