A Unique Case Of Tenofovir-Induced DRESS Syndrome Associated With Raynaud's Of The Tongue

Obadah Aqtash; Aman Naim Ajmeri; Brent A Thornhill; Elise Anderson; Ryan Carroll; Adee Elhamdani; Eva Tackett

doi:10.2147/IJGM.S215511

A Unique Case Of Tenofovir-Induced DRESS Syndrome Associated With Raynaud's Of The Tongue

Int J Gen Med. 2019 Oct 23:12:381-385. doi: 10.2147/IJGM.S215511. eCollection 2019.

Authors

Obadah Aqtash¹, Aman Naim Ajmeri¹, Brent A Thornhill¹, Elise Anderson², Ryan Carroll¹, Adee Elhamdani¹, Eva Tackett¹

Affiliations

¹ Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, USA.
² Charleston Area Medical Center, Charelston, WV 25701, USA.

Abstract

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a potentially fatal severe adverse reaction to medications. Numerous drugs have been implicated, with carbamazepine and allopurinol being the most common. Tenofovir-induced DRESS is extremely rare. We report a case of a 65-year-old male patient with a diffuse exfoliative maculopapular rash across his entire body of five weeks of duration. The patient also had icteric sclera, abnormal liver enzymes and Raynaud's of the tongue, nose and the left fifth finger. After discontinuation of tenofovir, the case resolved over a span of ten days. A high index of suspicion is crucial along with the prompt withdrawal of the offending medication for a good outcome.

Keywords: DRESS; Raynaud’s of the tongue; Raynaud’s phenomena; drug reaction with eosinophilia and systemic symptoms; tenofovir-induced DRESS; tenofovir.