TNF and drug hypersensitivity syndrome: During this period, activated T lymphocytes produce cytokines such as tumor necrosis factor-alpha, interleukin-6, and interferon-gamma, which are responsible for the pro-inflammatory state and organ dysfunction associated with severe DRESS syndrome [9]. Reactivation of a virus, commonly Human herpesvirus-6, mumps, Epstein-Barr virus, and cytomegalovirus, has been shown to exacerbate DRESS syndrome [6-7].