A Case of Drug-Induced Hypersensitivity Syndrome-Like Symptoms Following HHV-6 Encephalopathy
Background: Drug-induced hypersensitivity syndrome (DIHS) is a rare but severe disorder due to a systemic hypersensitivity reaction. We report on a case with DIHS-like symptoms following human herpes virus 6 (HHV-6) infection complicated with encephalopathy. Case Summary: An 11-month-old girl suffer...
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Elsevier
2010-01-01
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| Series: | Allergology International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1323893015305797 |
| _version_ | 1811221114938982400 |
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| author | Satoshi Saida Akira Yoshida Rieko Tanaka Junya Abe Keigo Hamahata Mitsuyoshi Okumura Toru Momoi |
| author_facet | Satoshi Saida Akira Yoshida Rieko Tanaka Junya Abe Keigo Hamahata Mitsuyoshi Okumura Toru Momoi |
| author_sort | Satoshi Saida |
| collection | DOAJ |
| description | Background: Drug-induced hypersensitivity syndrome (DIHS) is a rare but severe disorder due to a systemic hypersensitivity reaction. We report on a case with DIHS-like symptoms following human herpes virus 6 (HHV-6) infection complicated with encephalopathy.
Case Summary: An 11-month-old girl suffered from a human herpes virus 6 (HHV-6) infection (exanthema subitum) complicated with encephalopathy. We treated the patient with continuous infusion of thiopental, assisted mechanical ventilation, methylprednisolone pulse therapy, and γ-globulin infusion therapy starting on the fifth day of the illness and started phenobarbital administration on the eleventh day. The patient developed a fever, systemic erythematous exanthema, lymphadenopathy, and eosinophilia two weeks after the start of phenobarbital administration. Steroid therapy, methylprednisolone (4 mg/kg/day) followed by oral prednisolone (1 mg/kg/day), was started on the 28th day and was tapered off on the 72nd day after admission. Serum anti-HHV-6 IgG antibody elevation and the presence of HHV-6 DNA in the peripheral blood detected by polymerase chain reaction (PCR) analysis suggested reactivation of HHV-6 after the primary infection of HHV-6. Lymphocyte transformation test for phenobarbital was positive three weeks after the DIHS crisis.
Discussion: HHV-6 reactivation is a unique feature in DIHS. In general one develops DIHS accompanied by reactivation of HHV-6 which has been residing in the body since the initial infection (exanthema subitum) in early childhood. This is the first report of a patient with DIHS-like symptoms which developed immediately following the primary infection of HHV-6. |
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| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1323-8930 |
| language | English |
| last_indexed | 2024-04-12T07:53:41Z |
| publishDate | 2010-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Allergology International |
| spelling | doaj.art-caa33f2da4f0476e9fc274b651635cf02022-12-22T03:41:32ZengElsevierAllergology International1323-89302010-01-01591838610.2332/allergolint.09-CR-0090A Case of Drug-Induced Hypersensitivity Syndrome-Like Symptoms Following HHV-6 EncephalopathySatoshi Saida0Akira Yoshida1Rieko Tanaka2Junya Abe3Keigo Hamahata4Mitsuyoshi Okumura5Toru Momoi6Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.Background: Drug-induced hypersensitivity syndrome (DIHS) is a rare but severe disorder due to a systemic hypersensitivity reaction. We report on a case with DIHS-like symptoms following human herpes virus 6 (HHV-6) infection complicated with encephalopathy. Case Summary: An 11-month-old girl suffered from a human herpes virus 6 (HHV-6) infection (exanthema subitum) complicated with encephalopathy. We treated the patient with continuous infusion of thiopental, assisted mechanical ventilation, methylprednisolone pulse therapy, and γ-globulin infusion therapy starting on the fifth day of the illness and started phenobarbital administration on the eleventh day. The patient developed a fever, systemic erythematous exanthema, lymphadenopathy, and eosinophilia two weeks after the start of phenobarbital administration. Steroid therapy, methylprednisolone (4 mg/kg/day) followed by oral prednisolone (1 mg/kg/day), was started on the 28th day and was tapered off on the 72nd day after admission. Serum anti-HHV-6 IgG antibody elevation and the presence of HHV-6 DNA in the peripheral blood detected by polymerase chain reaction (PCR) analysis suggested reactivation of HHV-6 after the primary infection of HHV-6. Lymphocyte transformation test for phenobarbital was positive three weeks after the DIHS crisis. Discussion: HHV-6 reactivation is a unique feature in DIHS. In general one develops DIHS accompanied by reactivation of HHV-6 which has been residing in the body since the initial infection (exanthema subitum) in early childhood. This is the first report of a patient with DIHS-like symptoms which developed immediately following the primary infection of HHV-6.http://www.sciencedirect.com/science/article/pii/S1323893015305797drug-induced hypersensitivity syndromedrug-induced lymphocyte transformation testHHV-6 encephalopathyhypersensitivity syndromephenobarbital |
| spellingShingle | Satoshi Saida Akira Yoshida Rieko Tanaka Junya Abe Keigo Hamahata Mitsuyoshi Okumura Toru Momoi A Case of Drug-Induced Hypersensitivity Syndrome-Like Symptoms Following HHV-6 Encephalopathy Allergology International drug-induced hypersensitivity syndrome drug-induced lymphocyte transformation test HHV-6 encephalopathy hypersensitivity syndrome phenobarbital |
| title | A Case of Drug-Induced Hypersensitivity Syndrome-Like Symptoms Following HHV-6 Encephalopathy |
| title_full | A Case of Drug-Induced Hypersensitivity Syndrome-Like Symptoms Following HHV-6 Encephalopathy |
| title_fullStr | A Case of Drug-Induced Hypersensitivity Syndrome-Like Symptoms Following HHV-6 Encephalopathy |
| title_full_unstemmed | A Case of Drug-Induced Hypersensitivity Syndrome-Like Symptoms Following HHV-6 Encephalopathy |
| title_short | A Case of Drug-Induced Hypersensitivity Syndrome-Like Symptoms Following HHV-6 Encephalopathy |
| title_sort | case of drug induced hypersensitivity syndrome like symptoms following hhv 6 encephalopathy |
| topic | drug-induced hypersensitivity syndrome drug-induced lymphocyte transformation test HHV-6 encephalopathy hypersensitivity syndrome phenobarbital |
| url | http://www.sciencedirect.com/science/article/pii/S1323893015305797 |
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