Drug-induced hypersensitivity syndrome and …

1 56 12 2010 305.. 6. Drug-induced hypersensitivity syndrome and human herpesvirus 6.. Koji HASHIMOTO.. DIHS . DIHS Stevens- johnson DIHS . toxic epidermal neclolysis TEN . 1 . DDS DDS. dapsone, 4,4 -diaminodiphenylsulphone .. DIHS 2 4 . 6 HHV-6 . DIHS sulfapyridine-induced serum-sickness-like syndrome associated with plas- macytosis, lymphocytosis and multiclonal gamma- 2 . globulinopathy , allopurinol hypersensitivity syn- 3 4 . drome dilantin-serum sickness anticonvulsant 5 . hypersensitivity syndrome .. Drug-induced hypersensitivi- 1994 Roujeau 6 . ty syndrome : DIHS Stevens - johnson . toxic epidermal neclolysis TEN . DIHS hypersensitivity syndrome . Stevens - johnson TEN DRESS drug rash with eosiophila and 7.

2 15 systemic symptoms . 8 . DIHS 1998 Hashimoto Shiohara 9 . hypersensitivity syndrome HHV- 6 . 6 human herpesvirus . 6 : HHV-6 . DIHS hypersensitivity syndrome . DIHS . Stevens - johnson .. TEN .. Department of Dermatology Ehime University Graduate School of Medicine 0791 - 0295 (Shitsukawa, Toon, Ehime). 1 . 306.. DIHS . HHV-6. 2 6 .. D I H S.. 2 DIHS .. DIHS HHV- 6 .. 1 . 2 . 1 HHV- 6 . carbamazepine phenytoin pheno- DIHS 1 . barbital zonisamide DDS salazosulphapyridine . mexiletine allopurinol minocycline .. 2 DNA . carba- DNA . mazepine . 1 .. HHV- 6 .. 1 HHV-1 : 1 . 2 HHV- 2 : . 2 3 HHV- 3 : . 4. HHV- 4 : Epstein-Barr virus . 5 HHV-5 : CMV . 6 HHV-6 . 7 HHV-7 8 HHV-8 . 8 2 . DIHS HHV- 6 . HHV-6A HHV- 6B.

3 1 DIHS HHV- 6B DIHS. HHV- 6B 2 . 2 . 307. 1 Drug-induced hypersensitivity syndrome DIHS . 2005 .. 2 3 . HHV-6 .. 1.. 2. 2 . 3. 38 . 4.. 5. a, b, c . a. 11000/mm 3 . b. 5 % . c. 1500/mm 3 . 6.. 7. HHV-6 . DIHS 1 7 . DIHS 1 5 4 .. 1.. 2 6 . 2.. 3.. 4. HHV- 6 HHV- 6 IgG 4 2 . HHV- 6 DNA HHV- 6 DNA . 14 28 21 2 .. 5. HHV-6 HHV-7 EB . 6.. 2 DIHS . Human herpesvirus 1 Herpes simplex virus type 1 HSV-1 . Human herpesvirus 2 Herpes simplex virus type 2 HSV-2 . Human herpesvirus 3 Varicella-zoster virus VZV . Human herpesvirus 4 Epstein-Barr virus EBV . 22 . Human herpesvirus 5 Cytomegalovirus CMV . Human herpesvirus 6 Human herpesvirus 6 HHV-6 2 3 . Human herpesvirus 7 Human herpesvirus 7 HHV-7 . Human herpesvirus 8 Human herpesvirus 8 HHV-8 HHV-6 IgG HHV-6.

4 14 . HHV-6 HHV-6 IgG . DIHS GVHD 28 HHV-6 IgG . 3 HHV-6. HHV-6 10 28 . real-time real-time PCR . PCR HHV-6 . DIHS HHV-6. HHV-6 2 4 .. DIHS HHV-6 DIHS HHV-6 .. DIHS HHV-6 1998 DIHS . 8 9 . 100 HHV-6 IgG . HHV-6 HHV-6 62 HHV- 3 . 308. 6 IgG HHV-6 . 10 . 38 3-1, 2 . 5 . HHV-6 HHV-6 . HHV-6 . DIHS .. DIHS . 10 . 1 DIHS . HHV-6 .. HHV-6 DIHS .. 100000. DIHS . 1 . 10000. 2 DIHS 4 5 . 3 HHV- 6 HHV- HHV-6 IgG . 6 DNA loads 4 . 11 . 1000 .. DIHS . 100 . IgG. IgM . 10 DNA . 0 7 14 21 28 35 42 . DNA . 3 DIHS HHV- 6 IgG .. 2 4 .. 3-1 HHV- 6 HHV- 6 3-2 HHV- 6 HHV- 6 .. HHV- 6 IgG HHV- 6 IgG .. n = 62 n = 38 P n = 62 n = 38 P value 61 98% 29 76% 32 52% 7 18% 22 35% 2 5% 44 71% 10 26% 32 52% 2 5% 38 61% 8 21% 12 19% 5 13% 38 61% 19 50% 50 81% 27 71% 55 89% 20 53% 56 90% 30 79%.

5 15 24% 2 5% 10 16% 0 0% 5 8% 0 0% 4 . 309. DIHS .. DIHS EB HHV-7 DIHS Stevens- johnson . TEN . DIHS HHV-6 . EB HHV- 4 HHV- 7 . 12 . EB .. EB 1 Allday EJ, Bames J, Lond MB et al.: toxic effects of diaminodiphenylsulphone in treatment of leprosy. Lancet, HHV-7 . 2 : 205 -206, 1951. HHV-6 DNA 2 Han T, Chawla PL, Sokal JE : Sulfapyridine-induced EB HHV- serum-sickness-like syndrome associated with plasmacy- tosis, lymphocytosis and multiclonal gamma-globulinopa- 7 . thy. N Engl J Med, 280 : 547-548, 1969. 3 Singer JZ, Wallace SL : The allopurinol hypersensitivity syndrome . Arthritis Rheum, 29 : 82- 87, 1986. 4 Braberman IM, and Levin J. Dilantin-induced serum sick- . HHV-6 . ness. Case report and inquiry into its mechanism.

6 Am J. Med, 35 : 418 -422, 1963. HHV-6 T 5 Shear, N H, Spielberg, SP : Anticonvulsant syndrome : in vitro assessment of risk. J Clin Invest, 82 : 1826 -1832, 1988. DIHS. 13 . 6 Roujeau JC, Stern RS.: Severe adverse cutaneous rreac- HHV-6 . tions to drugs. N Eng J Med, 331 : 1272 -1285, 1994. 7 Bocquet H, Bagot M, Roujeau JC : Drug-induced psu- dolymphoma and drug hypersensitivity syndrome drug rash with eosinophilia and systemic symptoms : DRESS .. DIHS . Semin Cutan Med Surg, 15 : 250 -257, 1996. 8 Tohyama M, Yahata Y, Yasukawa M, et al. Severe hyper- sensitivity syndrome due to sulfasalazine associated with 30 50mg/ human herpes virus 6. Arch Dermatol 134 : 1113 -1117, 1998.. 9 Suzuki Y, Inagi R, Aono T, et al.

7 Human herpes virus 6. infection as a risk factor the development of severe drug- induced hypersensitivity syndrome . Arch Dermatol 134 : 14 1108 -1112, 1998.. 10 Tohyama M, Hashimoto K, Yasukawa M, et al. Associa- HHV-6 tion of human herpesvirus 6 reactivation with the flaring and severity of Drug-induced hypersensitivity syndrome . Br J Dermatol 157 : 934 - 940, 2007. 11 Asano Y, Kagawa H, Kano Y, et al. Cytomegarovirus dis- . ease during severe drug eruptions : report of 2 cases and retrospective study of 18 patients with Drug-induced hypersensitivity syndrome . Arch Dermatol 145 : 1030 - 1036, 2009.. 12 Seishima M, Yamanaka S, Fujisawa T, et al. Reactivation of human herpesvirus HHV family members other than DIHS HHV-6 in Drug-induced hypersensitivity syndrome .

8 Br J. Dermatol 155 : 344 - 349, 2006. 13 Kitamura K, Asada H, Fukumoto T, et al. Relationship . among human herpesvirus 6 reactivation, serum inter- DIHS leukin 10levels, and rash/graft-versus-host disease after allogeneic stem cell transplantation. J Am Acad Dermatol 5 . 310. 58 : 802 -809, 2008. 14 Kano Y, Inaoka M, Sakuma K, Shiohara T : Virus reactiva- tion and intravenous immunoglobulin IVIG therapy of Drug-induced hypersensitivity syndrome . Toxicology, 209. : 165 -167, 2005. 6.