Case reports and literature review: the association between reactivation of human herpes virus-6 and peripheral white blood cell count in patients with carbamazepine-induced hypersensitivity syndrome.
Eruptions induced by anticonvulsants can often be experienced clinically, and the clinical diagnosis of "drug induced hypersensitivity syndrome (HS)" was proposed to characterize these drug eruptions. Reactivation of human herpes virus-6 seems to be an integral component of HS. Previously, we experienced two cases of carbamazepine (an anticonvulsant) induced HS and both cases did not show a reactivation of human herpes virus-6 infection (no elevation of anti-human herpes virus-6 IgG titres). The features of these two cases were compared with other reported cases that presented HS with the reactivation of human herpes virus-6. In the early phase of HS, a change in peripheral white blood cell count seems to be important and could be used as an indicator to predict whether late phase HS with reactivation of human herpes virus-6 will occur, since the increase in white blood cell count is seen before the increase in anti-human herpes virus-6 titres. Reactivation of human herpes virus-6 may cause severe clinical symptoms such as encephalitis. When an increase in white blood cells are observed in HS cases at onset, immediate discontinuation of cause drug and intensive care are necessary to avoid the more severe symptoms of HS.
Department of Psychiatry, Juntendo Koshigaya Hospital, 560 Fukuroyama, Koshigaya-shi, Saitama 343-0032, Japan.
Kentaro
K
Matsuda
Tohru
T
Ohnuma
Mayuko
M
Fukuta
Masaaki
M
Kawai
Toshihito
T
Suzuki
Hideoki
H
Ogawa
Heii
H
Arai
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects; D002220:Carbamazepine / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000209:etiology* / Q000821:virology; D015654:Herpesvirus 6, Human / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D014775:Virus Activation / Q000187:drug effects*
D000927:Anticonvulsants; D002220:Carbamazepine