Drug-induced hypersensitivity syndrome due to mexiletine hydrochloride associated with reactivation of human herpesvirus 7.
It has been suggested that reactivation of human herpesvirus 6 (HHV-6) infection may be involved in the pathogenesis of drug-induced hypersensitivity syndrome. We report a 45-year-old Japanese man who developed a generalized papuloerythematous rash, fever, hepatitis, lymphadenopathy and lymphocytosis with an increased number of atypical lymphocytes. He was diagnosed with DIHS due to mexiletine hydrochloride based on laboratory data, results of a patch test and the clinical course of his complaint, and was treated with systemic steroids. In order to determine whether HHV-6 or -7 was associated with the patient's disease, serological assays and PCR were carried out. Significant increases in antibody titers against HHV-6 and -7 were observed from day 12 to 24. From PCR analysis, none of the peripheral blood mononuclear cells or skin tissue samples contained HHV-6 DNA. All samples, however, were found to contain HHV-7 DNA. Reactivation of HHV-7 could be responsible for drug-induced hypersensitivity syndrome.
Yagami
Akiko
A
Department of Dermatology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan. atomi@fujita-hu.ac.jp
Yoshikawa
Tetsushi
T
Asano
Yoshizo
Y
Koie
Shin
S
Shiohara
Tetsuo
T
Matsunaga
Kayoko
K
D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D000914:Antibodies, Viral / Q000032:analysis; D004279:DNA, Viral / Q000032:analysis; D003875:Drug Eruptions / Q000209:etiology / Q000821:virology; D004342:Drug Hypersensitivity / Q000209:etiology* / Q000821:virology; D015654:Herpesvirus 6, Human / Q000276:immunology; D016199:Herpesvirus 7, Human / Q000187:drug effects* / Q000235:genetics / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007964:Leukocytosis / Q000209:etiology / Q000821:virology; D008297:Male; D008801:Mexiletine / Q000009:adverse effects; D008875:Middle Aged; D019349:Roseolovirus Infections / Q000175:diagnosis / Q000276:immunology; D013577:Syndrome; D014775:Virus Activation / Q000187:drug effects*
D000889:Anti-Arrhythmia Agents; D000914:Antibodies, Viral; D004279:DNA, Viral; D007074:Immunoglobulin G; D008801:Mexiletine