PMID- 18094951
OWN - NLM
STAT- MEDLINE
DCOM- 20080226
LR  - 20220801
IS  - 1080-0549 (Print)
IS  - 1080-0549 (Linking)
VI  - 33
IP  - 1-2
DP  - 2007 Oct
TI  - A complex interaction between drug allergy and viral infection.
PG  - 124-33
AB  - A relationship between viral infections and the simultaneous or subsequent 
      development of drug rashes has been observed in a number of clinical situations. 
      We have recently provided evidence to indicate an intimate relationship between 
      reactivation of 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 unique features that cannot be 
      explained by a drug etiology; they include its delayed onset, paradoxical 
      worsening of clinical symptoms after discontinuation of the causative drugs, and 
      a step-wise development of several organ system failures long after clinical 
      resolution. Many aspects of this syndrome suggest close similarities between DIHS 
      and graft-versus-host disease (GVHD). Indeed, a wide variety of complications 
      frequently occurring in GVHD, such as autoimmune diseases, is often observed 
      during the course of this syndrome and even long after clinical resolution. Our 
      recent studies have shown that in DIHS sequential reactivations of several 
      herpesviruses (HHV-6, HHV-7, Epstein-Barr virus, and cytomegalovirus) can be 
      detected coincident with various clinical symptoms in the same order as 
      demonstrated in GVHD. Thus, not only the timing but also the order in which these 
      herpesviruses can be reactivated in the host would be crucial determinant of 
      outcomes of the disease. Our results indicate the importance of recognizing DIHS 
      and other drug rashes associated with viral infections at risk of eventually 
      developing autoimmune diseases.
FAU - Shiohara, Tetsuo
AU  - Shiohara T
AD  - Department of Dermatology, Kyorin University School of Medicine, Mitaka, Tokyo, 
      Japan. tpshio@kyorin-u.ac.jp
FAU - Kano, Yoko
AU  - Kano Y
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Clin Rev Allergy Immunol
JT  - Clinical reviews in allergy & immunology
JID - 9504368
RN  - 7C782967RD (Ampicillin)
SB  - IM
MH  - Ampicillin/adverse effects
MH  - Animals
MH  - Autoimmunity
MH  - Drug Hypersensitivity/diagnosis/*etiology
MH  - Graft vs Host Disease/etiology
MH  - Herpesvirus 6, Human/physiology
MH  - Humans
MH  - Infectious Mononucleosis/complications
MH  - Stevens-Johnson Syndrome/etiology
MH  - T-Lymphocytes/physiology
MH  - Virus Activation
MH  - Virus Diseases/*complications
RF  - 62
EDAT- 2007/12/21 09:00
MHDA- 2008/02/27 09:00
CRDT- 2007/12/21 09:00
PHST- 2007/12/21 09:00 [pubmed]
PHST- 2008/02/27 09:00 [medline]
PHST- 2007/12/21 09:00 [entrez]
AID - 10.1007/s12016-007-8010-9 [doi]
PST - ppublish
SO  - Clin Rev Allergy Immunol. 2007 Oct;33(1-2):124-33. doi: 
      10.1007/s12016-007-8010-9.