第4巻 2008年10月　第4号

■症例から学ぶ

薬剤性過敏症症候群（drug-induced hypersensitivity syndrome：DIHS）の1例
東　直行, 狩野　律子
日本医科大学多摩永山病院皮膚科

A Case of Drug-induced Hypersensitivity Syndrome
Naoyuki Higashi and Ritsuko Kano
Department of Dermatology, Nippon Medical School Tama Nagayama Hospital

Drug-induced hypersensitivity syndrome (DIHS) is a rare but severe disease associated with multiorgan failure. The association of DIHS with human herpes virus 6 (HHV-6) has recently been reported. We report on an 89-year-old woman with allopurinol-induced DIHS diagnosed on the basis of symptoms and laboratory examinations. A rash appeared as erythema on the trunk and extremities and edematous erythema on the face. Renal dysfunction, leukocytosis, eosinophilia, and atypical lymphocytes were also present. An elevated titer of antibodies against HHV-6 and HHV-6 DNA in the blood were observed during the course of the disease (1:20 to 1:1280). Discontinuation of allopurinol administration and systemic corticosteroid treatment led to an improvement, but symptoms worsened when the corticosteroid dosage was tapered. An elevated titer of antibodies against cytomegalovirus was detected during the course of the disease. The patient died of pneumonia, most likely related to cytomegalovirus. This case indicates that, in addition to the reactivation of HHV-6, reactivation of cytomegalovirus may modify clinical disease activity.

日医大医会誌 2008; 4(4), 205-209

Key words
drug-induced hypersensitivity syndrome, allopurinol, human herpes virus 6, cytomegalovirus

Correspondence to
Naoyuki Higashi, Department of Dermatology, Nippon Medical School Tama Nagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo 206-8512, Japan
E-mail：ton@nms.ac.jp

受付：2008年9月1日　受理：2008年9月16日