Human herpes virus 6 encephalitis in allopurinol-induced hypersensitivity syndrome.
Hypersensitivity syndrome is one of the most severe forms of drug eruption, and is characterized by a severe, potentially lethal, multiorgan involvement. Recently, reactivation of human herpesvirus 6 (HHV-6) has been suggested to be involved in this syndrome, although the exact role of HHV-6 remains elusive. In addition to exanthem subitum, neurological illnesses, such as infantile febrile illness without rash and encephalitis in immunocompromised patients have been attributed to HHV-6. A 51-year-old man developed a generalized erythematous eruption during treatment with allopurinol. Prednisolone improved his condition, but after the dose of prednisolone was reduced neurological abnormalities such as mental deterioration and positive meningeal signs developed. HHV-6 DNA in his blood by PCR analysis was positive. Furthermore, we detected HHV-6 DNA in the cerebrospinal fluid. The titers of anti-HHV-6-IgG increased during the course. His neurological symptoms gradually improved and no neurological sequelae were noted. Neurological abnormalities associated with hypersensitivity syndrome are very rare. However, the detection of HHV-6 DNA in the cerebrospinal fluid strongly indicates an involvement of reactivated HHV-6 in encephalitis.
Masaki
Taro
T
Division of Dermatology, Clinical Molecular Medicine, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Fukunaga
Atsushi
A
Tohyama
Mikiko
M
Koda
Yoshiyuki
Y
Okuda
Shiho
S
Maeda
Nobuya
N
Kanda
Fumio
F
Yasukawa
Masaki
M
Hashimoto
Koji
K
Horikawa
Tatsuya
T
Ueda
Masato
M
D000493:Allopurinol / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004342:Drug Hypersensitivity / Q000150:complications* / Q000188:drug therapy / Q000209:etiology; D020803:Encephalitis, Herpes Simplex / Q000150:complications*; D006074:Gout Suppressants / Q000009:adverse effects*; D015654:Herpesvirus 6, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000009:adverse effects; D012008:Recurrence
D000893:Anti-Inflammatory Agents; D006074:Gout Suppressants; D000493:Allopurinol; D011239:Prednisolone