DRESS syndrome associated with sulfasalazine: hematological aspects.
English version of a poster presented in French.
Rm Bennai1✉, H Mamad1, S Benkirane1, A Masrar1
- 1 Laboratoire Central d’Hématologie, CHU Ibn Sina, Rabat.
Received 5 October 2026 · Accepted 5 October 2026 · Published 5 October 2026 · Corrected 5 October 2026
DOI: https://doi.org/10.5281/zenodo.23165686
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Key messages
- Le syndrome de DRESS à la sulfasalazine se manifeste par une hyperéosinophilie et une lymphocytose atypique.
- Le frottis sanguin révèle des anomalies granulocytaires caractéristiques, notamment des polynucléaires neutrophiles hypolobés et hypogranulaires.
- La reconnaissance des signes hématologiques est cruciale pour éviter la confusion avec un processus néoplasique.
Abstract
Introduction
DRESS syndrome is a severe cutaneous reaction with systemic involvement, often related to certain drugs such as sulfasalazine. The objective is to determine the hematological profile of DRESS syndrome through the study of a case highlighting its clinical and biological manifestations.
Materials and methods
Study of a clinical case of a 43-year-old woman with rheumatoid arthritis who developed DRESS syndrome after progressive initiation of sulfasalazine. Clinical and biological evolution was monitored, including complete blood count, renal and hepatic function tests, lipase level, C-reactive protein (CRP), and viral PCR for HHV-6, HHV-7, and HHV-8.
Results
The complete blood count showed leukocytosis with neutrophilia and eosinophilia, with the appearance of atypical lymphocytosis. Biochemical parameters revealed normal lipase levels, initially decreased glomerular filtration rate (GFR), elevated transaminases, and high CRP levels. PCR detected HHV-6 viral DNA. Blood smear revealed atypical lymphocytes and hypolobated, hypogranular neutrophils.
Conclusion
The case is characterized by marked hypereosinophilia and atypical lymphocytosis with granulocytic abnormalities on the smear. Awareness of these findings and clinical presentation is essential to differentiate DRESS syndrome from an underlying hematologic neoplastic process.
Original poster
References
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