Case of lamotrigine-induced drug adverse reaction under tocilizumab treatment with clinical and virological features of drug-induced hypersensitivity syndrome
| Autor: | Takeya Adachi, Hiromi Ito, Miho Mukai, Takeru Funakoshi, Yuko Baba, Masayuki Amagai, Takeshi Ouchi, Hisashi Nomura, Miho Sawada, Hisato Iriki, Hayato Takahashi |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
0301 basic medicine Fever Biopsy Dermatology Lamotrigine Antibodies Monoclonal Humanized Arthritis Rheumatoid 030207 dermatology & venereal diseases 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Tocilizumab Drug adverse reaction Recurrence Drug-induced hypersensitivity syndrome Humans Medicine Interleukin 6 Pathological Herpesviridae Skin Epilepsy biology Interleukin-6 Triazines business.industry Interleukin General Medicine Exanthema Rash C-Reactive Protein 030104 developmental biology chemistry DNA Viral Drug Hypersensitivity Syndrome Immunology biology.protein Prednisone Anticonvulsants Female medicine.symptom business medicine.drug |
| Zdroj: | The Journal of Dermatology. 45:738-741 |
| ISSN: | 0385-2407 |
| DOI: | 10.1111/1346-8138.14288 |
| Popis: | The pathological mechanisms and immunological kinetics of drug-induced hypersensitivity syndrome (DIHS), including the relevance of interleukin (IL)-6, remain unclear. We report a case of drug adverse reaction that does not fulfill the diagnostic criteria of DIHS but mimics its characteristic features. Because the patient was under anti-IL-6 therapy at the onset, some symptoms typically seen in DIHS were absent, such as fever and leukocyte count abnormalities. However, the characteristic features of DIHS were clearly observed in the subsequent course, including the repeated recurrence of skin rash, prolonged liver dysfunction and reactivation of herpes viruses. This case suggested that IL-6 role at the onset is not a main factor to determine the subsequent pathomechanism of DIHS and attention should be paid to the preceding therapy for achieving accurate diagnosis. |
| Databáze: | OpenAIRE |
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