Journal
INTERNAL MEDICINE
Volume 55, Issue 13, Pages 1769-1774Publisher
JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.55.6287
Keywords
drug-induced hypersensitivity syndrome (DIHS); drug rash with eosinophilia and systemic symptoms (DRESS); eosinophilia; human herpes virus 6 (HHV-6); reactivation
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A 74-year-old man who had been administered trimethoprim-sulfamethoxazole for three weeks suffered from drug-induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms (DIHS/DRESS). In the early stage of the clinical course, he developed renal dysfunction. A renal biopsy showed granulomatous tubulointerstitial nephritis accompanying the proliferation of human herpes virus ( HHV)-6 in tubular epithelial cells. With corticosteroid therapy, the systemic rash and renal function gradually improved. The present patient is the second case of DIHS/DRESS demonstrating a possible reactivation of HHV-6 in the renal tissue. The clinical role of viral reactivation in DIHS/DRESS must be further elucidated.
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