Tohyama M, Yahata Y, Yasukawa M, Inagi R, Urano Y, Yamanishi K, Hashimoto K
Department of Dermatology, Ehime University School of Medicine, Japan.
Arch Dermatol. 1998 Sep;134(9):1113-7. doi: 10.1001/archderm.134.9.1113.
A severe adverse reaction to sulfasalazine therapy has been associated with hypersensitivity syndrome, the clinical features of which are similar to infectious mononucleosis. No serologic evidence of viral infections has been reported with this syndrome; however, human herpesvirus 6 infection has not been specifically investigated, which could cause an infectious mononucleosislike syndrome.
We report 2 cases of hypersensitivity syndrome induced by the use of sulfasalazine. The clinical features of the syndrome appeared 18 and 32 days after administration of sulfasalazine. Clinical signs included a maculopapular rash progressing to exfoliate erythroderma, fever, and lymphadenopathy. Leukocytosis, atypical lymphocytes, liver dysfunction, and renal disturbance were also observed. In 1 patient, human herpesvirus 6 variant B was isolated from peripheral blood mononuclear cells, and in both patients anti-human herpesvirus 6 IgG titers increased considerably.
Two cases of hypersensitivity syndrome due to sulfasalazine use were associated with the reactivation of human herpesvirus 6, which may be a required cause of hypersensitivity syndrome.
柳氮磺胺吡啶治疗的严重不良反应与超敏反应综合征有关，其临床特征类似于传染性单核细胞增多症。该综合征尚无病毒感染的血清学证据；然而，人类疱疹病毒6型感染尚未得到专门研究，而该病毒可引起类似传染性单核细胞增多症的综合征。
我们报告了2例因使用柳氮磺胺吡啶引起的超敏反应综合征。该综合征的临床特征在服用柳氮磺胺吡啶后18天和32天出现。临床体征包括进展为剥脱性红皮病的斑丘疹、发热和淋巴结病。还观察到白细胞增多、非典型淋巴细胞、肝功能障碍和肾功能紊乱。在1例患者中，从外周血单个核细胞中分离出人类疱疹病毒6型B变异株，且2例患者的抗人类疱疹病毒6型IgG滴度均显著升高。
2例因使用柳氮磺胺吡啶导致的超敏反应综合征与人类疱疹病毒6型的重新激活有关，这可能是超敏反应综合征的一个必要病因。
