Descamps V, Valance A, Edlinger C, Fillet A M, Grossin M, Lebrun-Vignes B, Belaich S, Crickx B
Dermatology Department, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, 75018 Paris, France.
Arch Dermatol. 2001 Mar;137(3):301-4.
There is a current debate regarding the association of human herpesvirus 6 (HHV-6) infection and drug reaction with eosinophilia and systemic symptoms (DRESS).
Seven consecutive patients hospitalized with DRESS were enrolled in a prospective study to evaluate evidence of active HHV-6 infection.
The imputable drugs were carbamazepine (5 patients), ibuprofen (1 patient), and sulfasalazine (1 patient). All patients were seropositive for anti-HHV-6 IgG antibodies. Anti-HHV-6 IgM antibodies were detected in 4 of the 7 patients with a seroconversion in 2 patients. Neither anti-cytomegalovirus nor anti-Epstein-Barr virus early antigen IgM antibody was detected. Human herpesvirus 6 genome was not detected by polymerase chain reaction in the first serum sample of all patients. It was weakly detected in skin lesions in the last patient tested by polymerase chain reaction but was not found in uninvolved skin.
The results suggest an association between HHV-6 active infection (primo-infection or reactivation) and severe DRESS. Absence of anti-cytomegalovirus or anti-Epstein-Barr virus early antigen IgM antibodies argues against a nonspecific viral reactivation. Human herpesvirus 6 infection may play a role in the development of DRESS in susceptible patients. Some drugs with reactive metabolites could favor reactivation and propagation of HHV-6.
目前关于人类疱疹病毒6型（HHV-6）感染与药物超敏反应伴嗜酸性粒细胞增多和全身症状（DRESS）之间的关联存在争议。
连续7例因DRESS住院的患者纳入一项前瞻性研究，以评估HHV-6活动性感染的证据。
可疑药物为卡马西平（5例）、布洛芬（1例）和柳氮磺胺吡啶（1例）。所有患者抗HHV-6 IgG抗体血清学检测均为阳性。7例患者中有4例检测到抗HHV-6 IgM抗体，其中2例出现血清学转换。未检测到抗巨细胞病毒和抗EB病毒早期抗原IgM抗体。所有患者的首份血清样本经聚合酶链反应均未检测到人类疱疹病毒6型基因组。在最后一名接受聚合酶链反应检测的患者的皮肤病变中微弱检测到该病毒，但在未受累皮肤中未发现。
结果提示HHV-6活动性感染（初次感染或再激活）与严重DRESS之间存在关联。未检测到抗巨细胞病毒或抗EB病毒早期抗原IgM抗体排除了非特异性病毒再激活。HHV-6感染可能在易感患者发生DRESS中起作用。一些具有反应性代谢产物的药物可能有利于HHV-6的再激活和传播。
