Serum thymus and activation-regulated chemokine is associated with the severity of drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome.
Serum thymus and activation-regulated chemokine is associated with the severity of drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome.
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血清胸腺和活化调节趋化因子与嗜酸性粒细胞增多和全身症状/药物诱发的过敏综合征的药物反应的严重程度相关。
DOI：
10.1111/bjd.16132
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Asada H
中科院分区：
文献类型：
--
作者：
Nakamura-Nishimura Y;Miyagawa F;Miyashita K;Ommori R;Azukizawa H;Asada H
亲爱的编辑，嗜酸性粒细胞增多症和全身症状的药物反应(DRESS)/药物诱导的超敏综合征(DIHS)是一种严重的药物诱导反应，人类疱疹病毒(HHV)-6重新激活。1-3我们曾报道DIHS患者血清胸腺和活化调节趋化因子(TARC)水平明显升高，提示TARC是DIHS早期诊断的有用标志物。4、5本研究探讨了DRESS/DIHS患者血清TARC水平与临床症状和实验室指标的相关性，并对16例DRESS/DIHS患者(男8例，女8例，中位年龄分别为44岁和68×5岁)的临床症状和实验室指标进行了评估。记录数据包括外周血单个核细胞HHV-6和人巨细胞病毒(CMV)DNA拷贝数、血清细胞因子和可溶性白介素2受体(sIL-2R)、血清TARC。这是在奈良医科大学伦理委员会的批准下进行的。血清TARC水平在急性期升高，皮疹缓解后下降。我们评估了急性期血清TARC峰值水平。我们首先使用我们开发的皮肤和粘膜损害的严重程度评分来评估临床症状与TARC的相关性。皮肤和粘膜损害的严重程度和发热持续时间(≥38C)与血清TARC水平呈正相关(图1a，b)。11例血清TARC值较高(≥为10000pgmL±1)的患者均发生了红皮病，而TARC值较低(10000pgmL±1)的5例患者中有3例发生了红皮病。正如先前报道的那样，血清TARC水平也与着装得分相关(r=0×35，P=0×18)。4、5此外，血清TARC水平最高的患者(105300pgmL±1)死于肾功能衰竭，提示TARC与严重并发症有关。6用TARC测定全血细胞计数与血液生化指标的相关性。异型淋巴细胞百分率、丙氨酸转氨酶和肌酐水平与血清TARC水平呈正相关
DEAR EDITOR, Drug reaction with eosinophilia and systemic symptoms (DRESS)/drug-induced hypersensitivity syndrome (DIHS) is a severe adverse drug-induced reaction with reactivation of human herpesvirus (HHV)-6. 1–3 We previously reported that serum thymus and activation-regulated chemokine (TARC) levels were markedly increased in patients with DIHS and suggested that TARC is a useful diagnostic marker of DIHS in the early stage. 4, 5 In this study, we determined whether serum TARC levels correlate with the severity of clinical symptoms and laboratory data in patients with DRESS/DIHS.We evaluated 16 patients with DRESS/DIHS (eight male and eight female, median age 44 years and 68Á5 years, respectively) for their clinical symptoms and laboratory data. Recorded data included copy numbers of HHV-6 and human cytomegalovirus (CMV) DNA in peripheral blood mononuclear cells, serum cytokines and soluble interleukin-2 receptor (sIL-2R), and serum TARC. This was carried out under the approval of the ethics committee at Nara Medical University. Serum TARC levels increased in the acute stage and decreased upon remission of the skin eruption. We evaluated the peak levels of serum TARC in the acute stage. We first evaluated the association of clinical symptoms with TARC using a severity score of skin and mucosal lesions that we developed. The severity of skin and mucosal lesions and the duration of fever (≥ 38 C) showed positive correlations with serum TARC levels (Fig. 1a, b). All 11 patients with a high level of serum TARC (≥ 10 000 pg mL À1) developed erythroderma, and three of five patients with a lower TARC level (< 10 000 pg mL À1) developed erythroderma. The serum TARC levels also correlated with the DRESS score (r= 0Á35, P= 0Á18), as previously reported. 4, 5 Moreover, the patient with the highest serum TARC level (105 300 pg mL À1) died of renal failure, suggesting that TARC is related to severe complications. 6 We next determined the correlations of complete blood count and blood biochemistry with TARC. The percentage of atypical lymphocytes, and alanine transaminase and creatinine levels were positively correlated with serum TARC levels