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Anesthetic Management of a Patient with DRESS Syndrome for Renal Transplantation

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but potentially life-threatening hypersensitivity reaction characterized by widespread erythematous skin eruptions with fever, lymphadenopathy and visceral involvement—hepatitis, nephritis, pericarditis, and pneumonitis...

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Autores principales: Kadam, P. G., Nama, R., Modi, M. P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Avicenna Organ Transplantation Institute 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5219585/
https://www.ncbi.nlm.nih.gov/pubmed/28078063
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author Kadam, P. G.
Nama, R.
Modi, M. P.
author_facet Kadam, P. G.
Nama, R.
Modi, M. P.
author_sort Kadam, P. G.
collection PubMed
description Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but potentially life-threatening hypersensitivity reaction characterized by widespread erythematous skin eruptions with fever, lymphadenopathy and visceral involvement—hepatitis, nephritis, pericarditis, and pneumonitis. There are numerous reports describing the management of such patients in intensive care units but hardly any describing the intraoperative anesthetic management of such patients. Herein, we report on a patient with DRESS syndrome who was scheduled for renal transplantation. The main goal in this case was to prevent a hypersensitive drug reaction intraoperatively and develop a safe alternative anesthesia plan for the patient. After pre-operative skin and intradermal tests, we chose the drugs that could be safely used for anesthesia. Usually general anesthesia is preferred for renal transplantation but in this patient we opted for combined spinal epidural anesthesia. Precautions that are to taken in such a case and the anesthetic management are discussed in detail herewith.
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spelling pubmed-52195852017-01-11 Anesthetic Management of a Patient with DRESS Syndrome for Renal Transplantation Kadam, P. G. Nama, R. Modi, M. P. Int J Organ Transplant Med Case Report Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but potentially life-threatening hypersensitivity reaction characterized by widespread erythematous skin eruptions with fever, lymphadenopathy and visceral involvement—hepatitis, nephritis, pericarditis, and pneumonitis. There are numerous reports describing the management of such patients in intensive care units but hardly any describing the intraoperative anesthetic management of such patients. Herein, we report on a patient with DRESS syndrome who was scheduled for renal transplantation. The main goal in this case was to prevent a hypersensitive drug reaction intraoperatively and develop a safe alternative anesthesia plan for the patient. After pre-operative skin and intradermal tests, we chose the drugs that could be safely used for anesthesia. Usually general anesthesia is preferred for renal transplantation but in this patient we opted for combined spinal epidural anesthesia. Precautions that are to taken in such a case and the anesthetic management are discussed in detail herewith. Avicenna Organ Transplantation Institute 2016 2016-11-01 /pmc/articles/PMC5219585/ /pubmed/28078063 Text en This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kadam, P. G.
Nama, R.
Modi, M. P.
Anesthetic Management of a Patient with DRESS Syndrome for Renal Transplantation
title Anesthetic Management of a Patient with DRESS Syndrome for Renal Transplantation
title_full Anesthetic Management of a Patient with DRESS Syndrome for Renal Transplantation
title_fullStr Anesthetic Management of a Patient with DRESS Syndrome for Renal Transplantation
title_full_unstemmed Anesthetic Management of a Patient with DRESS Syndrome for Renal Transplantation
title_short Anesthetic Management of a Patient with DRESS Syndrome for Renal Transplantation
title_sort anesthetic management of a patient with dress syndrome for renal transplantation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5219585/
https://www.ncbi.nlm.nih.gov/pubmed/28078063
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