TY - JOUR
T1 - Case of lamotrigine-induced drug adverse reaction under tocilizumab treatment with clinical and virological features of drug-induced hypersensitivity syndrome
AU - Iriki, Hisato
AU - Ouchi, Takeshi
AU - Ito, Hiromi
AU - Sawada, Miho
AU - Mukai, Miho
AU - Nomura, Hisashi
AU - Baba, Yuko
AU - Adachi, Takeya
AU - Funakoshi, Takeru
AU - Amagai, Masayuki
AU - Takahashi, Hayato
N1 - Publisher Copyright:
© 2018 Japanese Dermatological Association
PY - 2018/6
Y1 - 2018/6
N2 - 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.
AB - 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.
KW - drug adverse reaction
KW - drug-induced hypersensitivity syndrome
KW - interleukin-6
KW - lamotrigine
KW - tocilizumab
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U2 - 10.1111/1346-8138.14288
DO - 10.1111/1346-8138.14288
M3 - Article
C2 - 29569382
AN - SCOPUS:85044241172
SN - 0385-2407
VL - 45
SP - 738
EP - 741
JO - Journal of Dermatology
JF - Journal of Dermatology
IS - 6
ER -