Reactions 1406 - 16 Jun 2012

SCarbamazepine

Drug-induced hypersensitivity syndrome andhuman herpesvirus-6 reactivation: case report

A 45-year-old man developed drug-inducedhypersensitivity syndrome (DIHS) alongside humanherpesvirus-6 (HHV-6) reactivation during treatment withcarbamazepine.

The man was taking carbamazepine [dosage, route andtherapeutic indication not stated] for 3 months beforepresenting with fever, jaundice, vomiting, cough and anitchy rash. Carbamazepine was discontinued at this timeand his symptoms initially treated with antihistamines andantibiotics but with minimal effect. He was subsequentlyadmitted to hospital on the 20th day of illness forinvestigation of atypical measles. Physical examinationrevealed high-grade fever, erythema, generalisedmaculopapular rash, cervical lymphadenopathy, facialpuffiness, jaundice and scaling of the lips. Laboratory testsshowed elevated liver enzymes, leukocytosis andeosinophilia. Throat swab and blood tests were performedand tested positive for HHV-6. The diagnosis of typicalDIHS was confirmed as per the Japanese consensus groupcriteria, inclusive of HHV-6 reactivation.

The man was treated with a tapering course ofprednisolone over 3 months to which he had a favourableresponse. At the conclusion of treatment he tested negativefor HHV-6.Riyaz N, et al. Drug-induced hypersensitivity syndrome with human herpesvirus-6reactivation. Indian Journal of Dermatology, Venereology and Leprology 78:175-177, No. 2, Mar-Apr 2012. Available from: URL: http://dx.doi.org/10.4103/0378-6323.93635 - India 803071886

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Reactions 16 Jun 2012 No. 14060114-9954/10/1406-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved