PMID- 19127076
OWN - NLM
STAT- MEDLINE
DCOM- 20090609
LR  - 20131121
IS  - 1423-0097 (Electronic)
IS  - 1018-2438 (Linking)
VI  - 149
IP  - 2
DP  - 2009
TI  - Carbamazepine hypersensitivity syndrome triggered by a human herpes virus 
      reactivation in a genetically predisposed patient.
PG  - 173-7
LID - 10.1159/000189202 [doi]
AB  - A case of severe hypersensitivity syndrome, triggered by carbamazepine in the 
      presence of a concomitant active human herpes virus (HHV) 6 and 7 infection is 
      described. To further understand the molecular mechanism of this adverse 
      reaction, analyses of the genetic variants of human leukocyte antigen (HLA) and 
      of the epoxide hydrolase gene (EPHX1), previously associated with carbamazepine 
      hypersensitivity, were performed. A lymphocyte transformation test (LTT) was 
      conducted in order to detect drug-specific lymphocytes. In the hypersensitive 
      patient, 2 genetic factors previously associated with intolerance to 
      carbamazepine were detected: the allele HLA-A*3101 and homozygosity for the 
      variant allele of SNP rs1051740 in EPHX1. Drug-specific lymphocytes could be 
      detected by LTT when the HHV was active (positive PCR for viral DNA and increased 
      anti-HHV 6 IgG titer), but not when it was no longer active. In conclusion, we 
      document a case of severe carbamazepine hypersensitivity triggered by viral 
      reactivation in a patient presenting the interaction of 2 unfavorable genetic 
      factors.
CI  - Copyright 2009 S. Karger AG, Basel.
FAU - Calligaris, Lorenzo
AU  - Calligaris L
AD  - IRCCS Burlo Garofolo, Pediatric Clinic, University of Trieste, Trieste IT-34127, 
      Italy.
FAU - Stocco, Gabriele
AU  - Stocco G
FAU - De Iudicibus, Sara
AU  - De Iudicibus S
FAU - Marino, Sara
AU  - Marino S
FAU - Decorti, Giuliana
AU  - Decorti G
FAU - Barbi, Egidio
AU  - Barbi E
FAU - Carrozzi, Marco
AU  - Carrozzi M
FAU - Marchetti, Federico
AU  - Marchetti F
FAU - Bartoli, Fiora
AU  - Bartoli F
FAU - Ventura, Alessandro
AU  - Ventura A
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090106
PL  - Switzerland
TA  - Int Arch Allergy Immunol
JT  - International archives of allergy and immunology
JID - 9211652
RN  - 0 (Anticonvulsants)
RN  - 0 (HLA-A Antigens)
RN  - 0 (HLA-A*31:01 antigen)
RN  - 33CM23913M (Carbamazepine)
RN  - EC 3.3.2.- (Epoxide Hydrolases)
RN  - EC 3.3.2.9 (EPHX1 protein, human)
SB  - IM
MH  - Anticonvulsants/*adverse effects
MH  - Carbamazepine/*adverse effects
MH  - Cells, Cultured
MH  - Child
MH  - Drug Hypersensitivity/genetics/*virology
MH  - Epoxide Hydrolases/genetics
MH  - Female
MH  - Genetic Predisposition to Disease
MH  - Genotype
MH  - HLA-A Antigens/genetics
MH  - Herpesviridae Infections/*complications
MH  - *Herpesvirus 6, Human
MH  - *Herpesvirus 7, Human
MH  - Humans
MH  - Leukocytes, Mononuclear/drug effects/immunology/metabolism
MH  - Polymorphism, Single Nucleotide
MH  - Syndrome
MH  - Virus Activation/genetics/immunology
EDAT- 2009/01/08 09:00
MHDA- 2009/06/10 09:00
CRDT- 2009/01/08 09:00
PHST- 2008/07/18 00:00 [received]
PHST- 2008/09/30 00:00 [accepted]
PHST- 2009/01/08 09:00 [entrez]
PHST- 2009/01/08 09:00 [pubmed]
PHST- 2009/06/10 09:00 [medline]
AID - 000189202 [pii]
AID - 10.1159/000189202 [doi]
PST - ppublish
SO  - Int Arch Allergy Immunol. 2009;149(2):173-7. doi: 10.1159/000189202. Epub 2009 
      Jan 6.