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Acute renal failure in a 3-year-old child as part of the drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome following hepatitis A

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Abstract

We report on a 3-year-old Melanesian girl admitted for acute renal failure following subfulminant hepatitis A virus infection. While the child was slowly recovering from severe cytolytic hepatitis, she presented 8 weeks of protracted fever and major eosinophilia (30,000/μl); thereafter, acute renal failure (serum creatinine 295 μmol/l) occurred. Renal histology displayed diffuse eosinophilic infiltrate, with severe acute tubulointerstitial lesions associated with mild glomerular endocapillary proliferation and eosinophilic infiltrate, suggesting an immunoallergic mechanism. The child had received cefixime and cotrimoxazole 3 weeks prior to hospitalisation for the hepatitis A virus infection. The final diagnosis was of the syndrome drug reaction with eosinophilia and systemic symptoms or DRESS, induced by cefixime or cotrimoxazole and possibly triggered by the hepatitis A virus infection.

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Authors and Affiliations

  1. Pediatric Nephrology Unit, Assistance Publique—Hôpitaux de Paris, Hôpital Robert Debré, Paris, France

    Arnaud Garnier, El Hachmi El Marabet, Theresa Kwon, Véronique Baudouin, Georges Deschênes & Chantal Loirat

  2. Department of Pathology, Assistance Publique—Hôpitaux de Paris, Hôpital Robert Debré, Paris, France

    Michel Peuchmaur

  3. Pediatric Hepatology Unit, Assistance Publique—Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin Bicêtre, France

    Olivia Mourier

  4. Pediatric Nephrology Unit, Assistance Publique—Hôpitaux de Paris, Hôpital Robert Debré and Université Paris VII, Faculté de Médecine Denis Diderot, 48, boulevard Sérurier, 75019, Paris, France

    Arnaud Garnier

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  1. Arnaud Garnier
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  2. El Hachmi El Marabet
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  3. Theresa Kwon
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  4. Michel Peuchmaur
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  5. Olivia Mourier
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  6. Véronique Baudouin
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  7. Georges Deschênes
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  8. Chantal Loirat
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Correspondence to Arnaud Garnier.

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The authors declare that they have no conflict of interest.

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Garnier, A., El Marabet, E.H., Kwon, T. et al. Acute renal failure in a 3-year-old child as part of the drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome following hepatitis A. Pediatr Nephrol 23, 667–669 (2008). https://doi.org/10.1007/s00467-007-0676-y

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  • DOI: https://doi.org/10.1007/s00467-007-0676-y

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