PMID- 32162382
OWN - NLM
STAT- MEDLINE
DCOM- 20210208
LR  - 20210208
IS  - 1346-8138 (Electronic)
IS  - 0385-2407 (Print)
IS  - 0385-2407 (Linking)
VI  - 47
IP  - 5
DP  - 2020 May
TI  - Influence of corticosteroid therapy on viral reactivation in drug-induced 
      hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms.
PG  - 476-482
LID - 10.1111/1346-8138.15294 [doi]
AB  - Drug-induced hypersensitivity syndrome (DIHS)/drug reaction with eosinophilia and 
      systemic symptoms (DRESS) is a severe adverse drug reaction characteristically 
      associated with sequential reactivation of herpesviruses, such as human 
      herpesvirus 6 (HHV-6), Epstein-Barr virus (EBV), and cytomegalovirus (CMV). Since 
      systemic corticosteroids are thought to result in viral reactivation due to their 
      immunosuppressive effects, we clarified the influence of systemic corticosteroid 
      therapy on viral reactivation in DIHS/DRESS. Viral DNA in peripheral whole blood 
      and serum sIL-2R level were measured during the disease course in twenty 
      DIHS/DRESS patients. Six of seven patients treated without corticosteroids 
      experienced HHV-6 viremia associated with elevated serum sIL-2R levels. In 
      contrast, high-dose corticosteroids started within 1 week after onset tended to 
      inhibit the occurrence of HHV-6 reactivation with remarkable suppression of serum 
      sIL-2R level. Low-dose corticosteroids or late-start high-dose corticosteroids 
      did not suppress occurrence of HHV-6 viremia and the increase of sIL-2R levels. 
      HHV-6 load in the blood was clearly correlated with the serum sIL-2R level. On 
      the other hand, increased CMV load were found in patients treated with 
      corticosteroids regardless of the start time. The frequency of detection of EBV 
      DNA in peripheral blood was similarly observed in all groups. In conclusion, 
      high-dose corticosteroids started within 1 week tended to suppress HHV-6 
      reactivation through suppression of T cell activation. However, CMV proliferation 
      was promoted by corticosteroids regardless of the start time. These observations 
      suggested that careful consideration should be given to the dose and timing of 
      administration of systemic corticosteroids in the treatment of DIHS/DRESS.
CI  - (c) 2020 Japanese Dermatological Association.
FAU - Tohyama, Mikiko
AU  - Tohyama M
AUID- ORCID: 0000-0003-4756-0155
AD  - Department of Dermatology, National Hospital Organization Shikoku Cancer Center, 
      Matsuyama, 791-0280, Japan.
AD  - Department of Dermatology, Ehime University Graduate School of Medicine, Toon, 
      791-0295, Japan.
FAU - Hashimoto, Koji
AU  - Hashimoto K
AD  - Department of Dermatology, Ehime University Graduate School of Medicine, Toon, 
      791-0295, Japan.
FAU - Oda, Fumiko
AU  - Oda F
AD  - Department of Dermatology, Ehime University Graduate School of Medicine, Toon, 
      791-0295, Japan.
FAU - Namba, Chika
AU  - Namba C
AUID- ORCID: 0000-0002-6307-9516
AD  - Department of Dermatology, Ehime University Graduate School of Medicine, Toon, 
      791-0295, Japan.
FAU - Sayama, Koji
AU  - Sayama K
AD  - Department of Dermatology, Ehime University Graduate School of Medicine, Toon, 
      791-0295, Japan.
LA  - eng
PT  - Journal Article
DEP - 20200311
PL  - England
TA  - J Dermatol
JT  - The Journal of dermatology
JID - 7600545
RN  - 0 (DNA, Viral)
RN  - 0 (Glucocorticoids)
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cytomegalovirus/genetics/immunology/isolation & purification
MH  - DNA, Viral/isolation & purification
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Drug Hypersensitivity Syndrome/complications/diagnosis/*drug therapy/immunology
MH  - Female
MH  - Glucocorticoids/administration & dosage/*adverse effects
MH  - Herpesviridae Infections/blood/*diagnosis/immunology/virology
MH  - Herpesvirus 4, Human/genetics/immunology/isolation & purification
MH  - Herpesvirus 6, Human/genetics/immunology/isolation & purification
MH  - Humans
MH  - Immunosuppressive Agents/administration & dosage/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Severity of Illness Index
MH  - Virus Activation/*drug effects/immunology
MH  - Young Adult
PMC - PMC7754408
OTO - NOTNLM
OT  - cytomegalovirus
OT  - drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and 
      systemic symptoms
OT  - human herpesvirus 6
OT  - soluble interleukin-2 receptor
OT  - systemic corticosteroid
COIS- None declared.
EDAT- 2020/03/13 06:00
MHDA- 2021/02/09 06:00
PMCR- 2020/12/22
CRDT- 2020/03/13 06:00
PHST- 2019/09/02 00:00 [received]
PHST- 2020/02/03 00:00 [revised]
PHST- 2020/02/05 00:00 [accepted]
PHST- 2020/03/13 06:00 [pubmed]
PHST- 2021/02/09 06:00 [medline]
PHST- 2020/03/13 06:00 [entrez]
PHST- 2020/12/22 00:00 [pmc-release]
AID - JDE15294 [pii]
AID - 10.1111/1346-8138.15294 [doi]
PST - ppublish
SO  - J Dermatol. 2020 May;47(5):476-482. doi: 10.1111/1346-8138.15294. Epub 2020 Mar 
      11.