Abstract
We clinically analyzed 94 patients with drug-induced hypersensitivity syndrome reported between 1998 and 2004 in Japan (50 males and 44 females, age range 0–89 years old, mean age 48.2 years old). The main causative drugs were anticonvulsants (62 patients) containing carbamazepin (40 patients). The clinical features appeared at an average of 34.5 days after administration of the causative drugs. The average was longer in patients with HHV-6 reactivation. Maculopapular rash and erythroderma were the most common type of eruptions accompanied by facial edema, pustules, and bullae in some patients. Recurrence of symptoms was observed in 42.2% of the patients. Human herpes virus 6 (HHV-6) reactivation was observed in 76 of 94 patients. HHV-7, cytomegalovirus, and Epstein-Barr virus reactivation were observed in 10 of 19, in 8 of 15, and in 1 of 7 patients studied, respectively. In many of these patients, HHV-6 reactivation was also detected. Four patients who had HHV-6 reactivation died of myocarditis, multi-organ failure, and sepsis. There were no significant differences in clinical features between the patients with and without HHV-6 reactivation other than the interval between the first drug administration and the onset of the rash.
