Methods: We report, herein a case of furosemide-induced DRESS
Results: Case report: A 67-year-old man has received a multidrug therapy including captopril, nifedipine, allopurinol and furosemide for hypertension, gout and chronic renal failure. Six weeks after starting treatment, he developed a maculopapular itchy and edematous skin reaction, facial edema and fever. Chest X ray showed interstitial lung disease. The laboratory findings showed 2200/mm3 of eosinophils. Lactate deshydrogenase was at 600 UI/L. Creatinin level was at 307 µmol/L. The skin biopsy findings were in accordance with an hypersensitive reaction. The symptoms were thought to result from a hypersensitive reaction and allopurinol was withdrawn. The skin eruption extended and eosinophilia increased. Because the patient was dehydrated, furosemide was withdrawn. The clinical and biological symptoms resolved completely three weeks after furosemide withdrawal. So, furosemide was suspected to be the culprit drug. Allopurinol rechallenge was without any incident. Patch test to furosemide was negative. The patient has received another sulfonamide loop diuretic (bumetamide) without any incident
Conclusions: To the best of our knowledge, this is the first case of furosemide-induced DRESS without cross reactivity. The drug imputability was retained according to chronological and clinical criteria since the lack of reliable skin tests to sulfonamides agents.