Introduction:

DRESS syndrome is a severe drug-induced mucocutaneous and visceral reaction that can be fatal due to liver and kidney damage.

Case report:

A 46-year-old man developed a generalised, non-pruritic rash, together with fever, digestive symptoms, cervical lymphadenopathy and night sweats coinciding with the previous intake of allopurinol. On hospital admission, he was diagnosed with acute hepatitis and deterioration of renal function including oliguria, requiring urgent hemodialysis. After a multidisciplinary treatment by the nephrology, digestive and haematology departments, the patient was discharged with an improvement in renal function, although he continued to be monitored on an ambulatory service.

Conclusions:

Allopurinol, a widely used drug in clinical practice, can cause severe and life-threatening adverse reactions.

DRESS syndrome, being very rare, has no standardised treatment. Specifically in the case of the patient, early detection, combined with effective treatment, including plasma replacement with albumin, hemodialysis and corticosteroids, favourably influenced the patient’s evolution, with recovery of renal function.