Itoi-Ochi Saori, Nakagawa Yukinobu, Tanemura Atsushi, Hirao Makoto, Fujimoto Manabu
Department of Dermatology, Osaka University Graduate School of Medicine, Suita, Japan.
Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Case Rep Dermatol. 2019 Dec 17;11(3):334-337. doi: 10.1159/000504644. eCollection 2019 Sep-Dec.
We experienced a rare case of drug-induced hypersensitivity syndrome (DIHS) in which salazosulfapyridine (SASP) reactivated human herpesvirus 6 (HHV-6) and cytomegalovirus (CMV), which resulted in a relapse of skin symptoms after changing to mizoribine. At the time of recurrence of skin erythema after the initiation of mizoribine, the serum DNA titers of not HHV-6 but CMV were elevated. A drug-induced lymphocyte stimulation test was negative for mizoribine but positive for SASP. In this case, DIHS developed with SASP in association with HHV-6 and CMV reactivation. The immunocompromised state induced by herpes virus reactivation and mizoribine might have caused the relapse of skin erythema.
我们遇到了一例罕见的药物性超敏反应综合征（DIHS），其中柳氮磺胺吡啶（SASP）重新激活了人类疱疹病毒6型（HHV - 6）和巨细胞病毒（CMV），导致换成咪唑立宾后皮肤症状复发。在开始使用咪唑立宾后皮肤红斑复发时，血清中CMV而非HHV - 6的DNA滴度升高。药物诱导的淋巴细胞刺激试验对咪唑立宾呈阴性，但对SASP呈阳性。在这种情况下，DIHS是由SASP与HHV - 6和CMV重新激活共同引发的。疱疹病毒重新激活和咪唑立宾诱导的免疫功能低下状态可能导致了皮肤红斑复发。
