Dapsone-induced DRESS after infliximab-induced vasculitis: a case of cerebral infarction in the context of multiple drug reactions.

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a life-threatening condition characterised by peripheral eosinophilia, rash and multi-organ failure arising several weeks after exposure to the culprit medication. Although rare, DRESS syndrome triggered by specific agents has been associated with specific genetic polymorphisms more prevalent in different ethnic groups, including an association between dapsone-induced DRESS and Human Leukocyte Antigen (HLA)-B:13*01, a single nucleotide polymorphism more prevalent in those of Asian descent. DRESS and drug-related vasculitis may affect any organ system including the central nervous system (CNS), usually manifesting as encephalitis, meningitis or embolic cerebrovascular accidents related to eosinophilic cardiac disease and thrombosis.

Cardiac Imaging Modalities and Appropriate Use.

Cardiovascular imaging with calcium scoring computed tomography (CT), coronary CT angiography (CCTA), and cardiac MRI (CMR) have advanced rapidly over recent years. These imaging modalities have increased in availability, accessibility, and clinical practicality due to technological advances allowing for significant radiation dose reduction for high-quality CCTA and for rapid and reliable imaging techniques in CMR. Hardware and software developments are continually increasing efficiency and accuracy of postprocessing.