title: A case of drug-induced hypersensitivity syndrome-like symptoms following HHV-6 encephalopathy.
abstract: BACKGROUND
  Drug-induced hypersensitivity syndrome (DIHS) is a rare but severe disorder due to a systemic hypersensitivity reaction. We report on a case with DIHS-like symptoms following human herpes virus 6 (HHV-6) infection complicated with encephalopathy.
  
  
  METHODS
  An 11-month-old girl suffered from a human herpes virus 6 (HHV-6) infection (exanthema subitum) complicated with encephalopathy. We treated the patient with continuous infusion of thiopental, assisted mechanical ventilation, methylprednisolone pulse therapy, and gamma-globulin infusion therapy starting on the fifth day of the illness and started phenobarbital administration on the eleventh day. The patient developed a fever, systemic erythematous exanthema, lymphadenopathy, and eosinophilia two weeks after the start of phenobarbital administration. Steroid therapy, methylprednisolone (4 mg/kg/day) followed by oral prednisolone (1 mg/kg/day), was started on the 28th day and was tapered off on the 72nd day after admission. Serum anti-HHV-6 IgG antibody elevation and the presence of HHV-6 DNA in the peripheral blood detected by polymerase chain reaction (PCR) analysis suggested reactivation of HHV-6 after the primary infection of HHV-6. Lymphocyte transformation test for phenobarbital was positive three weeks after the DIHS crisis.
  
  
  CONCLUSIONS
  HHV-6 reactivation is a unique feature in DIHS. In general one develops DIHS accompanied by reactivation of HHV-6 which has been residing in the body since the initial infection (exanthema subitum) in early childhood. This is the first report of a patient with DIHS-like symptoms which developed immediately following the primary infection of HHV-6.
authors: Department of Pediatrics, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.
authors: Satoshi
authors: S
authors: Saida
authors: Akira
authors: A
authors: Yoshida
authors: Rieko
authors: R
authors: Tanaka
authors: Junya
authors: J
authors: Abe
authors: Keigo
authors: K
authors: Hamahata
authors: Mitsuyoshi
authors: M
authors: Okumura
authors: Toru
authors: T
authors: Momoi
mesh_terms: D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects; D001928:Brain Diseases, Metabolic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D003937:Diagnosis, Differential; D004342:Drug Hypersensitivity / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D004802:Eosinophilia; D005077:Exanthema Subitum / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D015654:Herpesvirus 6, Human / Q000472:pathogenicity / Q000502:physiology*; D006801:Humans; D007223:Infant; D008206:Lymphatic Diseases; D010634:Phenobarbital / Q000008:administration & dosage / Q000009:adverse effects; D012640:Seizures; D014775:Virus Activation
chemical_list: D000927:Anticonvulsants; D005938:Glucocorticoids; D010634:Phenobarbital