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Successful mepolizumab treatment for DRESS-induced refractory eosinophilic myocarditis and concurrent thyroiditis
  1. Kelvin Truong1,2,
  2. Shane Kelly3,
  3. Angela Bayly4 and
  4. Annika Smith1,2
  1. 1Department of Dermatology, Westmead Hospital, Westmead, New South Wales, Australia
  2. 2Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
  3. 3Department of Clinical Immunology, Blacktown Hospital, Blacktown, New South Wales, Australia
  4. 4Department of Tissue Pathology and Diagnostic Oncology, Westmead Hospital, Westmead, New South Wales, Australia
  1. Correspondence to Dr Kelvin Truong; kelvintruong1318{at}


Drug reaction with eosinophilia and systemic symptoms (DRESS) is a potentially life-threatening adverse drug reaction with a mortality rate of 10%. Interstitial nephritis, pneumonitis, myocarditis, meningitis, thyroiditis and pancreatitis are major causes of morbidity and mortality in this syndrome. Cessation of offending medication is paramount. There is paucity in high quality prospective studies guiding the treatment of DRESS, and there are no published therapeutic clinical trials in the treatment of corticosteroid refractory hypersensitivity myocarditis. The authors present a unique case of ciprofloxacin-induced DRESS with concurrent thyroiditis and refractory eosinophilic myocarditis that required mepolizumab and multiple immunosuppressants for successful treatment.

  • unwanted effects / adverse reactions
  • immunology
  • skin
  • dermatology
  • thyroiditis

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  • Contributors KT, SK, AB and AS made significant contributions to the design, acquisition and write-up of the work. KT, SK, AB and AS contributed to the revision of the work. KT, SK, AB and AS approved the final work. KT, SK, AB and AS agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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