PMID- 17075280
OWN - NLM
STAT- MEDLINE
DCOM- 20070118
LR  - 20091103
IS  - 1323-8930 (Print)
IS  - 1323-8930 (Linking)
VI  - 55
IP  - 1
DP  - 2006 Mar
TI  - Drug-induced hypersensitivity syndrome (DIHS): a reaction induced by a complex 
      interplay among herpesviruses and antiviral and antidrug immune responses.
PG  - 1-8
AB  - A relationship between viral infections and the simultaneous or subsequent 
      development of allergic inflammation has often been observed in various clinical 
      situations. Recent studies suggest an intimate relationship between reactivations 
      of herpesviruses including human herpesvirus 6 (HHV-6) and the development of a 
      severe systemic hypersensitivity reaction referred to as drug-induced 
      hypersensitivity syndrome (DIHS). This syndrome has several important clinical 
      features that cannot be solely explained by drug antigen-driven oligoclonal 
      expansion of T cells: they include paradoxical worsening of clinical symptoms 
      after discontinuation of the causative drug. In view of the similarity to GVHD or 
      immune reconstitution syndrome (IRS) in clinical manifestations and emergence of 
      viral infections, the clinical symptoms observed during the course of DIHS and 
      GVHD are likely to be mediated by antiviral T cells that can cross-react with the 
      drug and alloantigens, respectively. In considering common intrinsic properties 
      of the causative drugs to potentially induce immunosuppression, reconstitution of 
      a valid immune response to these viruses, which is typically observed in IRS, may 
      be the most crucial process that takes place after withdrawal of the causative 
      drug in patients with DIHS. Thus, this syndrome should be regarded as a reaction 
      induced by a complex interplay among several herpesviruses (EB virus, HHV-6, 
      HHV-7, and cytomegalovirus), antiviral immune responses, and drug-specific immune 
      responses. This review includes discussion of the pathomechanism, the clinical 
      symptoms, laboratory findings, pathological findings and therapy.
FAU - Shiohara, Tetsuo
AU  - Shiohara T
AD  - Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan. 
      tpshio@kyorin-u.ac.jp
FAU - Inaoka, Miyuki
AU  - Inaoka M
FAU - Kano, Yoko
AU  - Kano Y
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - England
TA  - Allergol Int
JT  - Allergology international : official journal of the Japanese Society of 
      Allergology
JID - 9616296
SB  - IM
MH  - Drug Eruptions/*immunology/physiopathology/virology
MH  - Drug Hypersensitivity/immunology/physiopathology/*virology
MH  - Eosinophilia/immunology/virology
MH  - Herpesvirus 6, Human/drug effects/*immunology
MH  - Humans
MH  - Roseolovirus Infections/complications/*immunology
MH  - Syndrome
RF  - 40
EDAT- 2006/11/01 09:00
MHDA- 2007/01/19 09:00
CRDT- 2006/11/01 09:00
PHST- 2005/11/02 00:00 [received]
PHST- 2006/11/01 09:00 [pubmed]
PHST- 2007/01/19 09:00 [medline]
PHST- 2006/11/01 09:00 [entrez]
AID - S1323-8930(15)30941-2 [pii]
AID - 10.2332/allergolint.55.1 [doi]
PST - ppublish
SO  - Allergol Int. 2006 Mar;55(1):1-8. doi: 10.2332/allergolint.55.1.