Acute Promyelocytic Leukemia with Drug-induced Hypersensitivity Syndrome Associated with Epstein-Barr Virus Infection

Atsushi SATOH; Toshiko IKAI; Hiroshi MIWA; Norikazu IMAI; Akihito HIRAMATSU; Emi TAJIMA; Hidesuke YAMAMOTO; Motohiro WAKABAYASHI; Kazuhisa MIURA; Masato ITO; Masato SHIKAMI; Akira IMAMURA; Hidetsugu MIHARA; Yoshiro KATO; Masakazu NITTA

doi:10.2169/internalmedicine.43.74

Hematological Diseases

Acute Promyelocytic Leukemia with Drug-induced Hypersensitivity Syndrome Associated with Epstein-Barr Virus Infection

Atsushi SATOH, Toshiko IKAI, Hiroshi MIWA, Norikazu IMAI, Akihito HIRAMATSU, Emi TAJIMA, Hidesuke YAMAMOTO, Motohiro WAKABAYASHI, Kazuhisa MIURA, Masato ITO, Masato SHIKAMI, Akira IMAMURA, Hidetsugu MIHARA, Yoshiro KATO, Masakazu NITTA

Author information

Atsushi SATOH
Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine
Toshiko IKAI
Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine
Hiroshi MIWA
Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine
Norikazu IMAI
Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine
Akihito HIRAMATSU
Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine
Emi TAJIMA
Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine
Hidesuke YAMAMOTO
Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine
Motohiro WAKABAYASHI
Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine
Kazuhisa MIURA
Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine
Masato ITO
Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine
Masato SHIKAMI
Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine
Akira IMAMURA
Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine
Hidetsugu MIHARA
Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine
Yoshiro KATO
Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine
Masakazu NITTA
Department of Internal Medicine, Division of Hematology, Aichi Medical University, School of Medicine

Keywords: drug-induced hypersensitivity syndrome, skin adverse reaction, Epstein-Barr virus (EBV), human herpes virus 6 (HHV-6), acute promyelocytic leukemia (APL)

JOURNAL OPEN ACCESS

2004 Volume 43 Issue 1 Pages 74-78

DOI https://doi.org/10.2169/internalmedicine.43.74

Details

Abstract

We report a case of acute promyelocytic leukemia (APL) with drug-induced hypersensitivity syndrome associated with Epstein-Barr virus (EBV) infection. A 33-year-old woman was admitted because of APL. After complete remission was obtained with the use of all-trans retinoic acid (ATRA), intensive chemotherapy was administered. She developed high grade fever and severe systemic erythematous eruptions followed by cervical lymphoadenopathy, hepatosplenomegaly, hepatitis and hypotension in a state of myelosuppression during consolidation chemotherapy. Systemic corticosteroids alleviated the symptoms. Since an anti-EB VCA IgM antibody titer was continuously positive, persistent infection of EBV was suspected. In this case, EBV infection may have contributed to the development of drug-induced hypersensitivity syndrome.

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