DRESS with delayed onset acute interstitial nephritis and profound refractory eosinophilia secondary to Vancomycin

Table 1 Laboratory Investigations (Initial)

Parameter	Value	Reference	(Units)	Parameter	Value	Reference	(Units)
Creatinine	120	50-100	umol/L	WBC	30.2	4.0-10.5	x10^9/L
Urea	6.5	3.0-6.5	umol/L	Eosinophils	3.62	0.0-0.4	x10^9/L
Sodium	126	135-145	mmol/L	Neutrophils	19.34	2.00-7.50	x10^9/L
Potassium	3.8	3.5-5.0	mmol/L	Lymphocytes	2.11	1.5-4.00	x10^9/L
Chloride	93	98-107	mmol/L	Hb	114	140-170	g/L
Glucose	5.0	3.5-11.1	mmol/L	Platelets	604	150-400	x10^9/L
Total Protein	49	60-80	g/L	ESR	20	< 30	mm/hr
Albumin	21	35-50	g/L	CRP	13.4	< 3.0	mg/L
INR	1.3	0.9-1.2		C3	1.22	0.80-1.8	g/L
Bilirubin	14	0-17	umol/L	C4	0.27	0.13-0.40	g/L
GGT	354	8-61	U/L	IgA	3.04	0.80-4.50	g/L
Alk Phos	708	56-119	U/L	IgD		< 140	mg/L
AST	163	12-45	U/L	IgE	70	< 129	IU/mL
ALT	144	7-40	U/L	IgG	13.02	6.00-16.00	g/L
CK	17	55-197	U/L	IgM	0.33	0.40-3.00	g/L
LDH	196	94-250	U/L
Lactate	3.1	0.5-2.2	mmol/L	c-ANCA	Negative
Blood cultures	Negative			p-ANCA	Negative
Hepatitis B&C	Negative			ANA	Negative
EBV serology	past exposure			ENA	Negative
Stool O&P	Negative			SPEP	Negative
Strongyloidiasis serology	Negative			UPEP	Negative

ISSN: 1710-1492