title: Drug-induced Liver Injury with HHV-6 Reactivation.
abstract: Liver dysfunction was identified in a 16-year-old boy hospitalized with high fever and abdominal pain and fullness. He had received pharmacotherapy for a headache 2 months previously and other drugs for a high fever 4 days prior to being admitted to our hospital. The patient's liver dysfunction was consistent with and fulfilled the criteria for drug induced liver injury, but the laboratory findings showed elevated procalcitonin levels, hyponatremia and leukocytosis. Moreover, we confirmed the presence of human herpesvirus 6 (HHV-6) DNA. The patient exhibited symptoms of high fever and abdominal pain and fullness but no exanthema. The clinical and laboratory findings did not satisfy the criteria for drug-induced hypersensitivity syndrome, and we speculate that the diversity of clinical and laboratory findings may have resulted from HHV-6 reactivation. To the best of our knowledge, this is the first case report on drug-induced liver injury with various findings due to HHV-6 reactivation. HHV-6 reactivation should be considered in patients with drug induced liver injury even in the absence of exanthema.
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Fujita
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takahashi
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Imaizumi
authors.forename: Manabu
authors.initials: M
authors.lastname: Hayashi
authors.forename: Ken
authors.initials: K
authors.lastname: Okai
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kanno
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Abe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ohira
mesh_terms: D015746:Abdominal Pain / Q000209:etiology* / Q000473:pathology / Q000821:virology; D000293:Adolescent; D056486:Chemical and Drug Induced Liver Injury / Q000150:complications* / Q000473:pathology; D005334:Fever / Q000209:etiology* / Q000473:pathology / Q000821:virology; D015654:Herpesvirus 6, Human / Q000302:isolation & purification / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D019349:Roseolovirus Infections / Q000150:complications* / Q000473:pathology; D014775:Virus Activation