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On broncho-alveolar lavage: Drug-specific T-lymphocytes and eosinophils may be found - Clinical course: o Rash and visceral involvement resolve in 6-9 weeks after withdrawal of offending agent o 20% of cases symptoms persist for months with remission and relapse - Diagnosis: o Pt who received new medication in the last 2-6 weeks with the following: - Morbilliform rash - Fever - Lymphadenopathy - Facial edema - Eosinophilia o Labs: CBC (eosinophilia), BMP (creatinine/BUN), viral hepatitis panel, dermatology referral for skin biopsy o CT chest if pulmonary symptoms - Management: o Drug withdrawal and supportive measures o If suspected medication is antiepileptic, substitute with valproate o For pts with hepatic involvement refer to hepatologist o For pts with severe interstitial nephritis or interstitial pneumonia, consider corticosteroids
Accessories: Fake beards for the dwarfs, a red bow for Snow White, and a shiny apple for the Evil Queen
