A group at the University of Pennsylvania performed a retroactive study of 29 pediatric patients hospitalized with drug hypersensitivity reactions and found that those who reactivated with HHV-6 had longer lengths of stay (11.5 days vs. 5. days) and more severe illness. They were not able to determine the impact of steroid administration in HHV-6 positive patients.
Drs. Ishida and Shiohara from Kyorin University in Tokyo have publised an inportant new study on the dynamics of herpesvirus reactivations during and after severe drug reactions. We asked them their thoughts on the implications of their findings.
In a recent study published in the European Journal of Allergy and Clinical Immunology, a group from Kyorin University School of Medicine in Tokyo sought to comprehensively record the dynamics of key herpesviruses beyond the acute stage of SJS/TEN. While EBV loads were higher in patients not receiving systemic corticosteroids, CMV and HHV-6 loads were higher in those receiving them.
A group of investigators in Japan have determined that HMGB-1, an inflammatory cytokine released in response to trauma, stress, and surgery, is highly elevated in DIHS/DRESS patients.
While elevated TNF-a detected at the early onset of disease is a strong indicator for the early recognition of HHV-6 reactivation, this finding also reflects important therapeutic information that could be used as an early diagnostic marker of DIHS/DRESS.
French panel of experts has proposed that DRESS patients be treated with antivirals and/or immunoglobulins.
Case report describes two cases of DRESS related thyroiditis with very high levels of HHV-6 reactivation that go on to develop autoimmunity.
A french group has found preliminary evidence that PCR saliva testing is useful for the detection of herpesvirus reactivation among patients with drug hypersensitivity syndromes.
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