Reactivation of human herpesvirus (HHV) family members other than HHV-6 in drug-induced hypersensitivity syndrome
Reactivation of human herpesvirus (HHV) family members other than HHV-6 in drug-induced hypersensitivity syndrome
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人类疱疹病毒（HHV）家族成员（HHV-6 除外）在药物诱发超敏综合征中的再活化
DOI：
10.1111/j.1365-2133.2006.07332.x
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发表时间：
2006-08-01
影响因子：
10.3
通讯作者：
Hashimoto, K.
中科院分区：
文献类型：
--
作者：
Seishima, M.;Yamanaka, S.;Hashimoto, K.
药物诱导的超敏反应综合征（DIHS）的特征是严重的多器官超敏反应，通常在暴露于某些药物（包括抗惊厥药）3-6周后出现。有报道表明，血清IgG水平往往在DIHS的早期阶段下降。在DIHS患者中已经报道了人类疱疹病毒（HHV）-6的再激活，并且一些其他DIHS患者显示巨细胞病毒（CMV）或EB病毒（EBV）的再激活。CMV和/或EBV在患有DIHS的患者中发生。其中7例在入院时和入院后不同时间使用间接免疫荧光抗体测定法测定。用酶免疫法测定抗CMV IgG和IgM抗体滴度，抗EBV衣壳抗原IgG、伊加、IgM，EBV核抗原和EBV早期抗原IgG滴度。用聚合酶链反应（PCR）检测HHV-6、HHV-7、CMV和EBV的DNA，发现HHV-6、HHV-7、CMV和EBV的IgG抗体在发病后分别有7、6、7和2例升高。HHV-6和HHV-7的IgG抗体滴度在发病后21-38天同时升高。HHV-6和HHV-7抗体滴度升高后10-21天，CMV和EBV的IgG抗体滴度升高。PCR检测HHV-6、HHV-7、CMV和EBV DNA阳性分别为6例、5例、7例和2例。HHV-6和HHV-7 DNA在发病后21-35天检出，CMV DNA在HHV-6和HHV-7 DNA检出后10-21天检出，提示部分DIHS患者药疹后除HHV-6再激活外，HHV-7、CMV和/或EBV也可再激活。
Drug-induced hypersensitivity syndrome (DIHS) is characterized by a severe multiorgan hypersensitivity reaction that usually appears after a 3-6-week exposure to certain drugs, including anticonvulsants. There are some reports showing that serum IgG levels often decrease at the early stage of DIHS. Reactivation of human herpesvirus (HHV)-6 has been reported in patients with DIHS, and some other DIHS patients showed reactivation of cytomegalovirus (CMV) or Epstein-Barr virus (EBV).To determine whether reactivation of HHV-6, HHV-7, CMV and/or EBV occurs in patients with DIHS.Titres of IgG and IgM antibodies to HHV-6 and HHV-7 were determined using an indirect immunofluorescence antibody assay on admission and at various times after admission. Anti-CMV IgG and IgM antibody titres and anti-EBV capsid antigen IgG, IgA, IgM, and EBV nuclear antigen and EBV early antigen IgG titres were determined by enzyme immunoassay. Polymerase chain reaction (PCR) procedures for HHV-6, HHV-7, CMV and EBV DNAs were performed using serum samples.IgG antibody titres to HHV-6, HHV-7, CMV and EBV were increased after the onset in seven, six, seven and two of seven patients, respectively. IgG antibody titres to HHV-6 and HHV-7 were elevated simultaneously 21-38 days after the onset. IgG antibody titres to CMV and EBV were elevated 10-21 days after the elevation of HHV-6 and HHV-7 antibody titres. PCR showed that HHV-6, HHV-7, CMV and EBV DNAs became positive in six, five, seven and two of seven patients, respectively. HHV-6 and HHV-7 DNAs were detected 21-35 days after the onset, and CMV DNA was detected 10-21 days after detection of HHV-6 and HHV-7 DNAs.The present study suggests that in addition to HHV-6 reactivation, reactivation of HHV-7, CMV and/or EBV may also occur following drug eruption in some patients with DIHS.