Zeliha HAYTOĞLU

Eozinofili ve Sistemik Semptomların Eşlik Ettiği İlaç Döküntüsü (DRESS) ile Eş Zamanlı Sitomegalovirus Enfeksiyonu

Eozinofili ve sistemik semptomların eşlik ettiği ilaç döküntüsü (DRESS) genellikle antikonvülzanların dahil olduğu birtakım ilaçlara, 3-6 hafta maruz kaldıktan sonra görünen şiddetli çoklu organ aşırı duyarlılık reaksiyonu ile karakterizedir. Birçok çalışmada insan Herpes Virüs 6 (HHV-6) reaktivasyonunun DRESS gelişimine katkıda bulunduğu gösterilmiştir. Bununla birlikte yakın dönemdeki çalışmalarda diğer Herpes virüslerden, Herpes virüs 7 (HHV-7), Ebstein-Barr virüs (EBV) ve Sitomegalovirus (CMV) reaktivasyonunun DRESS gelişimiyle ilişkili olduğu gösterilmiştir. Burada febril konvülsiyon profilaksisi için fenitoin kullanmakta olan 2 yaşında bir kız çocuğunda DRESS gelişimi ve eş zamanlı CMV viral yük varlığı gösterilmiştir.

Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Concurrent with Cytomegalovirus Infection

Drug rash with eosinophilia and systemic symptoms (DRESS) is characterized by a severe multiorgan hypersensitivity reaction that usually appears after a 3-6-week exposure to certain drugs, including anticonvulsants. Many reports have revealed that human herpesvirus 6 (HHV-6) reactivation contributes to the development of DRESS. In addition, recent articles have shown that reactivation of other herpesviruses such as human herpesvirus 7 (HHV-7), Epstein-Barr virus (EBV) and cytomegalovirus (CMV) might be also implicated in development of DRESS. Here we report development of the DRESS syndrome and concurrent presence of CMV viral load in a 2-year-old girl who was on phenytoin prophylaxis for febrile seizure.

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1. Bocquet H, Bagot M, Roujeau JC. Drug-induced pseudolymphoma and drug hypersensitivity syndrome (Drug Rash with Eosinophilia and Systemic Symptoms: DRESS). Semin Cutan Med Surg 1996;15:250-7.
2. Husain Z, Reddy BY, Schwartz RA. DRESS syndrome: Part I. Clinical perspectives. J Am Acad Dermatol 2013; 68:693.e1.
3. Husain Z, Reddy BY, Schwartz RA. DRESS syndrome: Part II. Management and therapeutics. J Am Acad Dermatol 2013; 68:709.e1.
4. Criado PR, Criado RFJ, Avancini JM, Santi CG. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)/Drug-Induced Hypersensitivity Syndrome (DIHS): A review of current concepts. An Bras Dermatol 2012;87:435-49.
5. Kardaun SH, Sidoroff A, Valeyrie-Allanore L, Halew S, Davidovici BB, Mockenhaupt M, et al. Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: Does a DRESS syndrome really exist? Br J Dermatol 2007;156:609-711.
6. Cacoub P, Musette P, Descamps V, Meyer O, Speirs C, Finzi L, et al. The DRESS syndrome: A literature review. Am J Med 2011;124:588-97.
7. Descamps V, Valance A, Edlinger C, Fillet AM, Grossin M, LebrunVignes B, et al. Association of human herpesvirus 6 infection with drug reaction with eosinophilia and systemic symptoms. Arch Dermatol 2001;137:301-4.
8. Kano Y, Hiraharas K, Sakuma K, Shiohara T. Several herpesviruses can reactivate in a severe drug-induced multiorgan reaction in the same sequential order as in graft-versus-host disease. Br J Dermatol 2006;155:301-6.
9. Hashizume H, Takigawa M. Drug-induced hypersensitivity syndrome associated with cytomegalovirus reactivation: Immunological characterization of pathogenic T cells. Acta Derm Venereol (Stockh) 2005;85:47-50.
10. Descamps V, Mahe E, Houhou N, Abramowitz L, Rozenberg F, Ranger Rogez S, et al. Drug-induced hypersensitivity syndrome associated with Epstein-Barr virus infection. Br J Dermatol 2003; 148:1032-34.
11. Tohyama M, Hashimoto K, Yasukawa M, Kimura H, Horikawa T, Nakajima K, et al. Association of human herpesvirus 6 reactivation with the flaring and severity of drug-induced hypersensitivity syndrome. Br J Dermatol 2007;157:934-40.
12. Picard D, Janela B, Descamps V, D'Incan M, Courville P, Jacquot S, et al. Drug reaction with eosinophilia and systemic symptoms (DRESS): A multiorgan antiviral T cell response. Sci Transl Med 2010;2:46ra62.
13. Ishida T, Kano Y, Mizukawa Y, Shiohara T. The dynamics of herpesvirus reactivations during and after severe drug eruptions: Their relation to the clinical phenotype and therapeutic outcome. Allergy 2014; 69: 798-805.
14. Aihara M, Sugita Y, Takehashi, Nagatani T, Arata S, Takeuchi K, et al. Anticonvulsant hypersensitivity syndrome associated with reactivation of cytomegalovirus. Br J Dermatol 2001;144:1231-4.
15. Viard L, Wehrli P, Bullani R, Schneider P, Holler N, Salomon D, et al. Inhibition of toxic epidermal necrolysis by blockade of CD95 with intravenous immunoglobulin. Science 1998;282:490-3.
16. Fields KS, Petersen MJ, Chiao E, Tristani-Firouzi P. Nevirapineassociated dress syndrome with intravenous immunoglobulin (IVIG). J Drugs Dermatol 2005;4:510-3.
17. Schneck J, Fagot JP, Sekula P, Sassalos B, Roujeau JC, Mockhenhaupt M. Effects of treatments of the mortality of Steven Johnson syndrome and toxic epidermal necrolysis; a retrospective study on patients included in the prospective EuroSCAR study. J Am Acad Dermatol 2008;58:33-40.
18. Tas S, Simonart T. Management of drug rash with eosinophilia and systemic symptoms (DRESS SYNDROME): An update. Dermatology 2003;206:353-6.
19. Kano Y, Inaoka M, Sakuma K, Shihora T. Virus reactivation and intravenous immunoglobulin (IVIG) therapy of drug-induced hypersensitivity syndrome. Toxicology 2005;209:165-7.