Suzuki Y, Inagi R, Aono T, Yamanishi K, Shiohara T
Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan.
Arch Dermatol. 1998 Sep;134(9):1108-12. doi: 10.1001/archderm.134.9.1108.
Drug-induced hypersensitivity syndrome is characterized by a severe, potentially fatal, multiorgan hypersensitivity reaction that usually appears after prolonged exposure to certain drugs. Its delayed onset and clinical resemblance to infectious mononucleosis suggest that underlying viral infections may trigger and activate the disease in susceptible individuals receiving these drugs.
A 60-year-old woman developed an itchy, generalized, erythematous, confluent rash on the 39th day of receiving allopurinol therapy. Even after she discontinued treatment with allopurinol, her skin lesions progressed to severe blistering skin eruption. After the patient started oral prednisone therapy, her skin lesions resolved with desquamation. After complete resolution, rechallenge with allopurinol led to the development of an erythematous eruption. Titers of human herpesvirus 6 IgG antibodies dramatically increased with the development of the eruption. The results of a polymerase chain reaction and in situ hybridization indicated the presence of human herpesvirus 6 in the skin lesions, although human herpesvirus 7 DNA was detected only by in situ hybridization.
Reactivation of human herpesvirus 6, possibly in concert with human herpesvirus 7, can contribute to the development of a severe drug-induced hypersensitivity syndrome.
药物性超敏反应综合征的特征是严重的、可能致命的多器官超敏反应，通常在长期接触某些药物后出现。其发病延迟且临床表现与传染性单核细胞增多症相似，提示潜在的病毒感染可能在接受这些药物的易感个体中触发并激活该疾病。
一名60岁女性在接受别嘌醇治疗的第39天出现瘙痒性、全身性、红斑性、融合性皮疹。即使她停用了别嘌醇治疗，其皮肤病变仍进展为严重的水疱性皮疹。患者开始口服泼尼松治疗后，皮肤病变消退并伴有脱屑。完全消退后，再次使用别嘌醇导致红斑疹出现。随着皮疹的发展，人疱疹病毒6 IgG抗体滴度显著升高。聚合酶链反应和原位杂交结果表明皮肤病变中存在人疱疹病毒6，尽管仅通过原位杂交检测到了人疱疹病毒7 DNA。
人疱疹病毒6的重新激活，可能与人疱疹病毒7协同作用，可导致严重的药物性超敏反应综合征的发生。
