Non-steroidal anti-inflammatory drug-induced DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome in a patient with multiple comorbidities

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is an acute drug reaction involving numerous organs. It mostly occurs 2 to 8 weeks after the offending agent is administered and presents with fever, rash, lymphadenopathy, eosinophilia, and dysfunction of organs, especially the liver, kidneys, and lungs. Drug-specific T-cells seem to be responsible for the pathogenesis of this condition, and there is a genetic component, such as HLA-B58, 01, associated with allopurinol hypersensitivity, which influences this reaction. We describe a 54-year-old male patient known case of diabetes mellitus, hypertension, ischemic heart disease, and chronic kidney disease stage 5 who developed DRESS syndrome after using non-steroidal anti-inflammatory drugs (NSAIDs) for body aches and fever. The patient displayed typical signs, such as renal failure (requiring dialysis), a noticeable eosinophilia on complete blood count, and exfoliating dermatitis. The Regi severe cutaneous adverse reactions criteria were used to confirm the diagnosis. The present study highlights how NSAIDs can cause DRESS syndrome, especially in patients who have other comorbidities. It highlights the necessity of aggressive management, prompt diagnosis, and increased clinical awareness to avoid potentially significant consequences like multi-organ failure. This case is significant because it shows that DRESS syndrome may be reversible with early detection and treatment, highlighting the need for careful NSAIDs use and close patient monitoring in vulnerable people.