Are Viral Infections Responsible for the Development of Drug-Induced Hypersensitivity Syndrome as well as Graft-versus-Host Diseases?

Shiohara, Tetsuo; Kano, Yoko

doi:10.1159/000084747

Cited by 15 publications

(18 citation statements)

References 9 publications

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“…Recently, we observed a patient who developed a severe generalised rash with liver dysfunction, associated with the reactivation of HHV-6 and cytomegalovirus (CMV), after exposure to TCE. In addition, the characteristics of this patient, including the clinical findings and period of reactivation of these two viruses after onset, closely resembled those of drug-induced hypersensitivity syndrome (DIHS) [4,5,6,7], also referred to as drug rash with eosinophilia and systemic symptoms (DRESS) [8,9]. This is the first report describing the reactivation of both HHV-6 and CMV in HS caused by TCE.…”

Section: Introductionmentioning

confidence: 63%

“…DIHS [4,5,6,7], which is also referred to as DRESS [8,9], is characterised by a serious adverse systemic reaction that usually appears after 3–6 weeks of exposure to certain drugs such as anticonvulsants and allopurinol [4,5,6,7]. DIHS is frequently associated with the reactivation of HHV-6 [4,5,6,7,9], and the reactivation of HHV-7, CMV or Epstein-Barr virus has also been reported [7,21,22].…”

Section: Discussionmentioning

confidence: 99%

“…DIHS is frequently associated with the reactivation of HHV-6 [4,5,6,7,9], and the reactivation of HHV-7, CMV or Epstein-Barr virus has also been reported [7,21,22]. When both HHV-6 and CMV are reactivated in the same patients with DIHS, HHV-6 DNA is detected 21–35 days after onset, followed 10–21 days later by positivity for CMV DNA; the CMV IgG antibody titre is also elevated 10–21 days after elevation of the HHV-6 antibody titre [23].…”

Section: Discussionmentioning

confidence: 99%

“…The prednisolone was tapered off with the improved clinical symptoms. Given the onset, and because the clinical findings including the facial oedema, scales and crusts around the nose and lips, maculopapular eruptions and relapse during the course were quite similar to those of DIHS/DRESS [4,5,6,7,8,9,10], we examined whether certain herpesviruses had been reactivated. As shown in table 1, serum HHV-6 DNA measured by using real-time PCR, as described previously [4,10], was detected 4 weeks after the onset (and only at this point).…”

Section: Case Reportmentioning

confidence: 99%

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Occupational Trichloroethylene Hypersensitivity Syndrome with Human Herpesvirus-6 and Cytomegalovirus Reactivation

Watanabe¹,

Tohyama²,

Kamijima³

et al. 2010

Dermatology

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Patients having a generalised rash with severe liver dysfunction associated with exposure to trichloroethylene (TCE) have been reported mainly in Asian countries. However, no case has been reported in Japan since the 1990s. Here, we describe a case of hypersensitivity syndrome (HS) caused by TCE in a 30-year-old Japanese man. The patient developed a rash, fever and liver dysfunction 21 days after he had been exposed to TCE at his workplace. Serum human herpesvirus (HHV)-6 and cytomegalovirus (CMV) DNA were detected 4 and 7 weeks, respectively, after the onset; the IgG antibody titres to HHV-6 and CMV were significantly elevated 6 and 9 weeks, respectively, after the onset. Patch testing was positive for the metabolites of TCE (i.e. trichloroethanol, trichloroacetic acid and chloral hydrate) but not for TCE itself; these results suggest that the TCE metabolites induced this disease. Human leucocyte antigen-B*1301, which has been reported to be strongly associated with TCE-induced HS, was identified in this patient. In addition, the clinical findings, laboratory data and period of virus reactivation after onset were quite similar to those of drug-induced hypersensitivity syndrome (DIHS). We also review TCE-induced HS from the viewpoint of the similarity to DIHS in this article.

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Section: Introductionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

See 2 more Smart Citations

Occupational Trichloroethylene Hypersensitivity Syndrome with Human Herpesvirus-6 and Cytomegalovirus Reactivation

Watanabe¹,

Tohyama²,

Kamijima³

et al. 2010

Dermatology

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show abstract

“…It is thus a challenging task for the future to verify if the drug-induced forms are exclusively drug related or if a drug-induced viral reactivation or interaction is responsible for the eruption [19] . Patients with a drug-induced hypersensitivity syndrome often have human herpesvirus 6, Epstein-Barr virus or cytomegalovirus reactivation [20,21] . It might indeed be postulated that the clinical phenotype, the disease expression, of at least some of these eruptions, is directly and specifi cally virus related and corresponds to the end of a chain reaction that might be triggered by many factors including other viruses (human-herpesvirus-7-induced human herpesvirus 6 reactivation in pityriasis rosea?…”

mentioning

confidence: 99%