{"id":"https://openalex.org/W7160220331","doi":"https://doi.org/10.7759/cureus.108236","title":"Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome With Predominant Renal Involvement and Cholestatic Liver Injury: A Case Report","display_name":"Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome With Predominant Renal Involvement and Cholestatic Liver Injury: A Case Report","publication_year":2026,"publication_date":"2026-05-04","ids":{"openalex":"https://openalex.org/W7160220331","doi":"https://doi.org/10.7759/cureus.108236","pmid":"https://pubmed.ncbi.nlm.nih.gov/42245842","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13232551"},"language":"en","primary_location":{"id":"doi:10.7759/cureus.108236","doi":"https://doi.org/10.7759/cureus.108236","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.108236","pdf_url":"https://www.cureus.com/articles/490233-drug-reaction-with-eosinophilia-and-systemic-symptoms-dress-syndrome-with-predominant-renal-involvement-and-cholestatic-liver-injury-a-case-report.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"parent_works":[],"lineage":["https://openalex.org/W7160220331"],"child_works_count":0,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://www.cureus.com/articles/490233-drug-reaction-with-eosinophilia-and-systemic-symptoms-dress-syndrome-with-predominant-renal-involvement-and-cholestatic-liver-injury-a-case-report.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5071180601","display_name":"Tamar Megrelishvili","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I7848551","display_name":"Tbilisi State Medical University","ror":"https://ror.org/020jbrt22","country_code":"GE","type":"education","lineage":["https://openalex.org/I7848551"]}],"countries":["GE"],"is_corresponding":false,"raw_author_name":"Tamar Megrelishvili","raw_affiliation_strings":["Department of Infectious Diseases, The First University Clinic of Tbilisi State Medical University, Tbilisi, GEO"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Infectious Diseases, The First University Clinic of Tbilisi State Medical University, Tbilisi, GEO","institution_ids":["https://openalex.org/I7848551"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5116478985","display_name":"Elene Saribekovi","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I7848551","display_name":"Tbilisi State Medical University","ror":"https://ror.org/020jbrt22","country_code":"GE","type":"education","lineage":["https://openalex.org/I7848551"]}],"countries":["GE"],"is_corresponding":true,"raw_author_name":"Elene Saribekovi","raw_affiliation_strings":["Department of Infectious Diseases, Tbilisi State Medical University, Tbilisi, GEO"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Infectious Diseases, Tbilisi State Medical University, Tbilisi, GEO","institution_ids":["https://openalex.org/I7848551"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5090719030","display_name":"Elene Pachkoria","orcid":"https://orcid.org/0000-0002-6273-9455","observed_orcids":["https://orcid.org/0000-0002-6273-9455"]},"institutions":[{"id":"https://openalex.org/I7848551","display_name":"Tbilisi State Medical University","ror":"https://ror.org/020jbrt22","country_code":"GE","type":"education","lineage":["https://openalex.org/I7848551"]}],"countries":["GE"],"is_corresponding":false,"raw_author_name":"Elene Pachkoria","raw_affiliation_strings":["Department of Infectious Diseases, The First University Clinic of Tbilisi State Medical University, Tbilisi, GEO"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Infectious Diseases, The First University Clinic of Tbilisi State Medical University, Tbilisi, GEO","institution_ids":["https://openalex.org/I7848551"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5086177628","display_name":"Tamar Didbaridze","orcid":"https://orcid.org/0000-0001-7485-4330","observed_orcids":["https://orcid.org/0000-0001-7485-4330"]},"institutions":[{"id":"https://openalex.org/I7848551","display_name":"Tbilisi State Medical University","ror":"https://ror.org/020jbrt22","country_code":"GE","type":"education","lineage":["https://openalex.org/I7848551"]}],"countries":["GE"],"is_corresponding":false,"raw_author_name":"Tamar Didbaridze","raw_affiliation_strings":["Department of Microbiology, The First University Clinic of Tbilisi State Medical University, Tbilisi, GEO"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Microbiology, The First University Clinic of Tbilisi State Medical University, Tbilisi, GEO","institution_ids":["https://openalex.org/I7848551"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5108712015","display_name":"Ia Mikadze","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I7848551","display_name":"Tbilisi State Medical University","ror":"https://ror.org/020jbrt22","country_code":"GE","type":"education","lineage":["https://openalex.org/I7848551"]}],"countries":["GE"],"is_corresponding":false,"raw_author_name":"Ia Mikadze","raw_affiliation_strings":["Department of Infectious Diseases, The First University Clinic of Tbilisi State Medical University, Tbilisi, GEO"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Infectious Diseases, The First University Clinic of Tbilisi State Medical University, Tbilisi, GEO","institution_ids":["https://openalex.org/I7848551"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5083762874","display_name":"Magda Rurua","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I7848551","display_name":"Tbilisi State Medical University","ror":"https://ror.org/020jbrt22","country_code":"GE","type":"education","lineage":["https://openalex.org/I7848551"]}],"countries":["GE"],"is_corresponding":false,"raw_author_name":"Magda Rurua","raw_affiliation_strings":["Department of Anesthesiology and Critical Care Medicine, The First University Clinic of Tbilisi State Medical University, Tbilisi, GEO"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Anesthesiology and Critical Care Medicine, The First University Clinic of Tbilisi State Medical University, Tbilisi, GEO","institution_ids":["https://openalex.org/I7848551"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5024973439","display_name":"L Ratiani","orcid":"https://orcid.org/0009-0002-3255-1811","observed_orcids":["https://orcid.org/0009-0002-3255-1811"]},"institutions":[{"id":"https://openalex.org/I7848551","display_name":"Tbilisi State Medical University","ror":"https://ror.org/020jbrt22","country_code":"GE","type":"education","lineage":["https://openalex.org/I7848551"]}],"countries":["GE"],"is_corresponding":false,"raw_author_name":"Levan Ratiani","raw_affiliation_strings":["Department of Anesthesiology and Critical Care Medicine, The First University Clinic of Tbilisi State Medical University, Tbilisi, GEO"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Anesthesiology and Critical Care Medicine, The First University Clinic of Tbilisi State Medical University, Tbilisi, GEO","institution_ids":["https://openalex.org/I7848551"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5116478985"],"corresponding_institution_ids":["https://openalex.org/I7848551"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"18","issue":"5","first_page":"e108236","last_page":"e108236"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11117","display_name":"Drug-Induced Adverse Reactions","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2736","display_name":"Pharmacology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11117","display_name":"Drug-Induced Adverse Reactions","score":0.9984999895095825,"subfield":{"id":"https://openalex.org/subfields/2736","display_name":"Pharmacology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12600","display_name":"Eosinophilic Disorders and Syndromes","score":0.0005000000237487257,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11943","display_name":"Pharmacovigilance and Adverse Drug Reactions","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/3005","display_name":"Toxicology"},"field":{"id":"https://openalex.org/fields/30","display_name":"Pharmacology, Toxicology and Pharmaceutics"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/drug-reaction-with-eosinophilia-and-systemic-symptoms","display_name":"DRESS syndrome","score":0.902999997138977},{"id":"https://openalex.org/keywords/drug-induced-hypersensitivity-reaction","display_name":"drug-induced hypersensitivity reaction","score":0.8029999732971191},{"id":"https://openalex.org/keywords/acute-kidney-injury","display_name":"acute kidney injury","score":0.8600000143051147},{"id":"https://openalex.org/keywords/cholestatic-liver-injury","display_name":"cholestatic liver injury","score":0.9729999899864197},{"id":"https://openalex.org/keywords/amoxicillin-clavulanic-acid","display_name":"amoxicillin-clavulanic acid","score":0.953000009059906},{"id":"https://openalex.org/keywords/corticosteroid-therapy","display_name":"corticosteroid therapy","score":0.8730000257492065},{"id":"https://openalex.org/keywords/atypical-presentation","display_name":"atypical presentation","score":0.621999979019165},{"id":"https://openalex.org/keywords/eosinophilia","display_name":"eosinophilia","score":0.7369999885559082},{"id":"https://openalex.org/keywords/hhv-6-reactivation","display_name":"HHV-6 reactivation","score":0.796999990940094}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9890999794006348},{"id":"https://openalex.org/C2777129736","wikidata":"https://www.wikidata.org/wiki/Q505142","display_name":"Eosinophilia","level":2,"score":0.6292999982833862},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.6021999716758728},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.5485000014305115},{"id":"https://openalex.org/C2780035454","wikidata":"https://www.wikidata.org/wiki/Q8386","display_name":"Drug","level":2,"score":0.5332000255584717},{"id":"https://openalex.org/C2993432071","wikidata":"https://www.wikidata.org/wiki/Q45959","display_name":"Drug reaction","level":3,"score":0.46779999136924744},{"id":"https://openalex.org/C2780542314","wikidata":"https://www.wikidata.org/wiki/Q45959","display_name":"Adverse drug reaction","level":3,"score":0.46619999408721924},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.3147999942302704},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.30070000886917114},{"id":"https://openalex.org/C2780091579","wikidata":"https://www.wikidata.org/wiki/Q9377","display_name":"Kidney","level":2,"score":0.2786000072956085},{"id":"https://openalex.org/C2779060952","wikidata":"https://www.wikidata.org/wiki/Q2068896","display_name":"Drug allergy","level":3,"score":0.2599000036716461},{"id":"https://openalex.org/C16005928","wikidata":"https://www.wikidata.org/wiki/Q171171","display_name":"Dermatology","level":1,"score":0.2563000023365021}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.7759/cureus.108236","doi":"https://doi.org/10.7759/cureus.108236","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.108236","pdf_url":"https://www.cureus.com/articles/490233-drug-reaction-with-eosinophilia-and-systemic-symptoms-dress-syndrome-with-predominant-renal-involvement-and-cholestatic-liver-injury-a-case-report.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},{"id":"pmid:42245842","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42245842","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Case Reports"},{"id":"pmh:oai:pubmedcentral.nih.gov:13232551","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13232551/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.7759/cureus.108236","doi":"https://doi.org/10.7759/cureus.108236","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.108236","pdf_url":"https://www.cureus.com/articles/490233-drug-reaction-with-eosinophilia-and-systemic-symptoms-dress-syndrome-with-predominant-renal-involvement-and-cholestatic-liver-injury-a-case-report.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7160220331.pdf","grobid_xml":"https://content.openalex.org/works/W7160220331.grobid-xml"},"referenced_works_count":12,"referenced_works":["https://openalex.org/W1531271463","https://openalex.org/W1987108253","https://openalex.org/W1992323259","https://openalex.org/W3112985499","https://openalex.org/W4285394439","https://openalex.org/W4318483805","https://openalex.org/W4362721355","https://openalex.org/W4378348606","https://openalex.org/W4383722242","https://openalex.org/W4400849420","https://openalex.org/W4416773464","https://openalex.org/W7131438350"],"related_works":["https://openalex.org/W4390618993","https://openalex.org/W4414076965","https://openalex.org/W4417527589","https://openalex.org/W4408228121","https://openalex.org/W3153044116","https://openalex.org/W4392364662","https://openalex.org/W4389731235","https://openalex.org/W4376503961","https://openalex.org/W7131438350","https://openalex.org/W4416718502"],"abstract_inverted_index":{"Drug":[0],"reaction":[1,17],"with":[2,70,82,123,153,206],"eosinophilia":[3,73],"and":[4,22,49,84,86,103,136,142,157,210,229],"systemic":[5],"symptoms":[6],"(DRESS)":[7],"syndrome":[8],"is":[9,178],"a":[10,36,57,63,118,124,170],"rare":[11],"but":[12],"potentially":[13],"life-threatening":[14],"drug-induced":[15],"hypersensitivity":[16],"characterized":[18],"by":[19],"delayed":[20],"onset":[21],"variable":[23],"multi-organ":[24],"involvement,":[25],"which":[26],"can":[27],"complicate":[28],"timely":[29],"diagnosis.":[30],"We":[31],"report":[32],"the":[33,111,115,163,191,199,220],"case":[34,146,197],"of":[35,60,120,127,151,165,193,201,222],"75-year-old":[37],"female":[38],"who":[39],"developed":[40],"fever,":[41],"generalized":[42],"pruritic":[43],"maculopapular":[44],"rash,":[45],"facial":[46],"edema,":[47],"lymphadenopathy,":[48],"acute":[50,79,212],"kidney":[51,80,213],"injury":[52,81,90,214],"10":[53],"days":[54],"after":[55,215],"completing":[56],"one-week":[58],"course":[59],"amoxicillin-clavulanate":[61],"for":[62,234],"respiratory":[64],"infection.":[65],"Laboratory":[66],"evaluation":[67],"revealed":[68],"leukocytosis":[69],"neutrophilia,":[71],"mild":[72],"not":[74],"meeting":[75],"diagnostic":[76,171],"threshold":[77],"criteria,":[78],"proteinuria":[83],"hematuria,":[85],"isolated":[87,158],"cholestatic":[88,159],"liver":[89,160],"without":[91],"significant":[92],"ALT":[93],"or":[94],"AST":[95],"elevation;":[96],"atypical":[97,149],"lymphocytosis":[98],"was":[99],"absent.":[100],"Autoimmune":[101],"serology":[102],"viral":[104,174],"hepatitis":[105],"screening":[106],"were":[107],"negative.":[108],"Based":[109],"on":[110],"RegiSCAR":[112],"scoring":[113],"system,":[114],"patient":[116],"achieved":[117],"score":[119],"7,":[121],"consistent":[122],"definite":[125],"diagnosis":[126],"DRESS.":[128],"Systemic":[129],"corticosteroid":[130],"therapy,":[131],"alongside":[132],"adjunctive":[133],"topical":[134],"treatment":[135],"antihistamines,":[137],"led":[138],"to":[139,190],"progressive":[140],"clinical":[141],"laboratory":[143],"improvement.":[144],"This":[145],"represents":[147],"an":[148],"presentation":[150],"DRESS":[152,182,203],"predominantly":[154],"renal":[155],"involvement":[156],"injury,":[161],"where":[162],"absence":[164,221],"typical":[166],"hematologic":[167,224],"manifestations":[168],"posed":[169],"challenge.":[172],"Although":[173],"reactivation,":[175],"particularly":[176],"HHV-6,":[177],"often":[179],"implicated":[180],"in":[181,204,219],"pathogenesis,":[183],"its":[184],"role":[185],"here":[186],"remains":[187],"unconfirmed":[188],"due":[189],"lack":[192],"virological":[194],"testing.":[195],"The":[196],"highlights":[198],"importance":[200],"considering":[202],"patients":[205],"delayed-onset":[207],"cutaneous":[208],"eruptions":[209],"unexplained":[211],"drug":[216],"exposure,":[217],"even":[218],"classic":[223],"features,":[225],"as":[226],"early":[227],"recognition":[228],"appropriate":[230],"management":[231],"are":[232],"crucial":[233],"favorable":[235],"outcomes.":[236]},"counts_by_year":[],"updated_date":"2026-11-10T11:39:43.021295","created_date":"2026-05-05T00:00:00"}