A case of drug-induced hypersensitivity syndrome showing transient immunosuppression before viral reactivation during treatment for pemphigus foliaceus.
Drug-induced hypersensitivity syndrome (DIHS) is one of the most severe drug adverse reactions, with characteristic biphasic symptoms. Reactivation of human herpesvirus-6 (HHV-6) is frequently observed, although the cause of DIHS is still unknown. A patient developed DIHS during treatment with diaminodiphenylsulphone for pemphigus foliaceus. The number of lymphocytes in his peripheral blood, and titres of serum total IgG and IgM and anti-desmoglein1 antibody transiently decreased just before reactivation of HHV-6, cytomegalovirus and Epstein-Barr virus. This observation suggests that transient suppression of both cellular and humoral immunity may trigger viral reactivation, which leads to the development of the second phase of DIHS.
Takahashi
H
H
Department of Dermatology, Keio University School of Medicine, Tokyo, Japan. hayato_takahashi@2000.jukuin.keio.ac.jp
Tanaka
M
M
Tanikawa
A
A
Toyohara
A
A
Ogo
Y
Y
Morimoto
A
A
Harato
R
R
Kobayashi
M
M
Amagai
M
M
D000284:Administration, Oral; D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000009:adverse effects; D003587:Cytomegalovirus / Q000276:immunology; D003622:Dapsone / Q000008:administration & dosage / Q000009:adverse effects; D051183:Desmoglein 1 / Q000276:immunology; D004342:Drug Hypersensitivity / Q000097:blood / Q000276:immunology* / Q000821:virology; D004854:Herpesvirus 4, Human / Q000276:immunology; D015654:Herpesvirus 6, Human / Q000276:immunology / Q000502:physiology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D018655:Lymphocyte Count; D008297:Male; D010392:Pemphigus / Q000097:blood / Q000188:drug therapy* / Q000276:immunology; D014775:Virus Activation
D000890:Anti-Infective Agents; D051183:Desmoglein 1; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D003622:Dapsone