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Karuppannasamy D, Andavar R, Arumugam J, Muthuvel K. DRESS Syndrome Secondary to Carbamazepine Therapy Presenting with Bilateral Acute Anterior Uveitis and Angle Closure Glaucoma. JOVR [Internet]. 2019Jul.18 [cited 2024Jun.3];14(3):382–386. Available from: https://knepublishing.com/index.php/JOVR/article/view/4795

https://doi.org/10.18502/jovr.v14i3.4795

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authors

  • Divya Karuppannasamy

    Divya Karuppannasamy

    Department of Ophthalmology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
  • Raghuram Andavar

    Raghuram Andavar

    Department of Ophthalmology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
  • Jayavardhana Arumugam

    Jayavardhana Arumugam

    Department of Paediatrics, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
  • Kumaresan Muthuvel

    Kumaresan Muthuvel

    Department of Dermatology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India

Published Date

  • Jul 18, 2019
This journal is publishing all the articles under Creative Commons Attribution License CC BY 4.0.

DRESS Syndrome Secondary to Carbamazepine Therapy Presenting with Bilateral Acute Anterior Uveitis and Angle Closure Glaucoma

Journal of Ophthalmic and Vision Research (JOVR) / July–September 2019, Volume 14, Issue 3 / Pages 382–386

Abstract

Purpose: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare, lifethreatening multi-system adverse drug reaction characterized by febrile skin rash, hematologic abnormalities, and involvement of internal organs. We report a case of DRESS syndrome in a child presenting with primary ophthalmic manifestations.


Case Report: An 11-year-old boy presented with severe pain and diminished vision in both eyes six weeks after starting carbamazepine therapy for seizure disorder. Ocular examination revealed features of bilateral acute anterior uveitis, acute onset myopia, and angle closure glaucoma secondary to uveal effusion. Additionally, the patient was febrile with a generalized maculopapular rash, and blood investigations revealed eosinophilic leukocytosis. A diagnosis of carbamazepine-induced DRESS syndrome was made, and carbamazepine therapy was discontinued. Treatment with cycloplegics, topical, and systemic steroids resulted in prompt clinical recovery.


Conclusion: Ophthalmologists should be aware that hypersensitivity to anticonvulsants, such as carbamazepine, can present with bilateral uveitis and uveal effusion along with systemic symptoms. Prompt diagnosis and treatment can prevent vision loss and life-threatening complications. Patients should be counselled about potential adverse effects of anticonvulsants before therapy.

Keywords:

Anterior Uveitis; Carbamazepine; DRESS Syndrome

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