Human herpesvirus infection in drug-induced hypersensitivity syndrome, toxic epidermal necrolysis and Stevens-Johnson syndrome
Human herpesvirus infection in drug-induced hypersensitivity syndrome, toxic epidermal necrolysis and Stevens-Johnson syndrome
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人类疱疹病毒感染导致药物过敏综合征、中毒性表皮坏死松解症和史蒂文斯-约翰逊综合征
DOI：
10.1046/j.1440-1592.2003.00309.x
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发表时间：
2004
影响因子：
6.8
通讯作者：
Z. Ikezawa
中科院分区：
文献类型：
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作者：
M. Aihara;Naoko Mitani;Natsue Kakemizu;Y. Yamakawa;N. Inomata;Norihiko Ito;H. Komatsu;Y. Aihara;Z. Ikezawa
摘要背景在药物诱导的超敏反应综合征（DIHS）患者中观察到人类疱疹病毒（HHV）感染，特别是HHV-6感染的再激活。在中毒性表皮坏死松解症（TEN）和Stevens-Johnson综合征（SJS）中，HHV感染与症状的相关性尚不清楚。方法选择2009年1月至2010年12月在我院住院的2009年12月至2011月在我院住院的2009年12月在我院住院的2009年1通过血清学试验和血液聚合酶链反应对这些患者进行了活动性HHV-6、HHV-7和巨细胞病毒（CMV）感染的评估。结果发病3周后，6例患者血清HHV-6 IgG抗体明显升高，其中1例未经激素治疗。从3名患者的血液中检测到人类疱疹病毒-6 DNA。在1例DIHS患者中，CMV再活化，而HHV-6未再活化，而在3例患者中，抗CMV IgG抗体在抗HHV-6 IgG抗体升高后升高。抗HHV-7 IgG抗体在这些患者中均未显示显著升高。对于TEN和SJS患者，抗HHV-6、抗HHV-7和抗CMV IgG抗体未显示显著增加，除了1例患者在类固醇治疗后抗HHV-6和抗HHV-7 IgG抗体增加，但不超过1：160。在这些患者的血液中未检测到人类疱疹病毒-6 DNA。结论DIHS患者的人类疱疹病毒6型再激活不是由于类固醇治疗诱导的非特异性再激活，而是由于DIHS特异性事件。我们推测，DIHS可能是由于HHV（尤其是HHV-6）的再活化，伴随着对药物的过敏反应，随后对病毒产生大量免疫反应，这可能是内脏受累的原因。
ABSTRACT Background Reactivation of human herpesvirus (HHV) infection, especially HHV-6, has been observed in patients with drug-induced hypersensitivity syndrome (DIHS). In toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS), the relevance of HHV infection to the symptoms is unclear. Methods Patients with a diagnosis of DIHS ( n = 7), TEN ( n = 5) and SJS ( n = 4) were included in the present study. These patients were evaluated for the presence of active HHV-6, HHV-7 and cytomegalovirus (CMV) infections by serological tests and polymerase chain reaction with blood. Results More than 3 weeks after the onset of DIHS, HHV-6 serological tests revealed a remarkable rise in IgG antibodies in six patients, including one treated without steroids. Human herpesvirus-6 DNA was detected in blood from three patients. In one patient with DIHS, reactivation of CMV was shown without reactivation of HHV-6, whereas in three patients anti-CMV IgG antibodies increased after the rise of anti-HHV-6 IgG antibodies. Anti-HHV-7 IgG antibodies did not show remarkable rises in any of these patients. As for patients with TEN and SJS, anti-HHV-6, anti-HHV-7 and anti-CMV IgG antibodies showed no significant increase, except for one patient in whom anti-HHV-6 and anti-HHV-7 IgG antibodies increased, but not more than 1: 160, after steroid therapy. Human herpesvirus-6 DNA was not detected in the blood of those patients. Conclusions Human herpesvirus-6 reactivation in patients with DIHS is not due to non-specific reactivation induced by steroid therapy, but to events specific to DIHS. We hypothesize that DIHS may occur as a result of reactivation of HHV, especially HHV-6, accompanied with an allergic reaction to drugs, followed by a substantial immune response to the virus that is probably responsible for visceral involvement.
Tanaka N 等人：“在不相关的脐带血移植中监测四种疱疹病毒。”骨髓移植。
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Keiko Tanaka-Taya：“人类疱疹病毒 7 号感染导致人类疱疹病毒 6 号重新激活”医学病毒学杂志。
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