Evidence for human herpesvirus-6B infection of regulatory T-cells in acute systemic lymphadenitis in an immunocompetent adult with the drug reaction with eosinophilia and systemic symptoms syndrome: A case report

Mine, Sohtaro; Suzuki, Koyu; Sato, Yuko; Fukumoto, Hiroki; Kataoka, Michiyo; Inoue, Naoki; Ohbayashi, Chiho; Hasegawa, Hideki; Sata, Tetsutaro; Fukayama, Masashi; Katano, Harutaka

doi:10.1016/j.jcv.2014.08.025

Cited by 22 publications

(13 citation statements)

References 22 publications

(35 reference statements)

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“…Many members of the Hepeviridae family have been reported to be reactivated in DIHS patients. A few reports demonstrated these latent viruses pathologically: HHV-6 in monocytes of skin lesions (2), atypical Reed-Sternberg-like cells of lymph nodes (20), and Treg cells of lymph nodes (21); and CMV in skin lesions (22). The present case showed inclusion bodies and multinucleated giant cells in the lung specimens, which suggest that the causal virus might have been a member of the Herpesviridae family, which are commonly found in latent infections in humans.…”

Section: Discussionmentioning

confidence: 99%

Bronchoscopic Investigation of Atypical Drug-induced Hypersensitivity Syndrome Showing Viral Lung Involvement

et al. 2016

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We herein report a case of atypical drug-induced hypersensitivity syndrome (DIHS) involving serological reactivation of cytomegalovirus induced by carbamazepine with pulmonary and skin manifestations. These lesions were not present on admission, but developed on virus reactivation as indicated by the presence of inclusion bodies and multinucleated giant cells in alveolar cells with CD8 + T lymphocyte infiltration on a transbronchial lung biopsy. Although the precise mechanism of DIHS remains unknown, this case suggests the crucial role of viral reactivation in pulmonary lesions in DIHS.

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Section: Discussionmentioning

confidence: 99%

Bronchoscopic Investigation of Atypical Drug-induced Hypersensitivity Syndrome Showing Viral Lung Involvement

et al. 2016

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“…Autoimmune thyroiditis and diabetes mellitus frequently arise post-DIHS/DRESS, as does chronic fatigue. HHV-6 has been detected in Treg cells in a case of likely DIHS/DRESS [ 244 ], and HHV-6A [ 245 ] and HHV-6B [ 246 ] are also able to induce the development of Treg cells. Both upregulated and reduced levels of Tregs have been reported in ME/CFS [ 217 , 221 , 247 ].…”

Section: Molecular Mechanisms Behind Viral Pathogenesis In Me/cfsmentioning

confidence: 99%

Chronic viral infections in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

et al. 2018

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Background and main textMyalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex and controversial clinical condition without having established causative factors. Increasing numbers of cases during past decade have created awareness among patients as well as healthcare professionals. Chronic viral infection as a cause of ME/CFS has long been debated. However, lack of large studies involving well-designed patient groups and validated experimental set ups have hindered our knowledge about this disease. Moreover, recent developments regarding molecular mechanism of pathogenesis of various infectious agents cast doubts over validity of several of the past studies.ConclusionsThis review aims to compile all the studies done so far to investigate various viral agents that could be associated with ME/CFS. Furthermore, we suggest strategies to better design future studies on the role of viral infections in ME/CFS.

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“… 143 High level HHV-6 viremia is often found in these patients, and HHV-6 DNA and antigen has been detected in the CSF of patients with encephalitis and hemophagocytosis, 143 , 144 the livers of patients with hepatitis and liver failure, 143 , 145 the kidneys of patients with renal dysfunction and failure, 146 , 147 and the bone marrow of patients with hemophagocytic syndrome. 148 , 149 HHV-6 is thought to contribute to the clinical manifestations of DIHS/DRESS, especially the atypical lymphocytosis, 150 lymphadenitis, 141 and multiorgan involvement, and viremia is predictive of a more severe course and flaring of symptoms, including hepatitis and fever, 151 as is hemophagocytosis. 140 Additionally, administration of valganciclovir has improved the condition of patients with severe DIHS/DRESS.…”

Section: Atypical/unusual Lymphoproliferative Disorders and Lymphocytmentioning

confidence: 99%

“… 143 , 147 , 149 HHV-6 has been found in hepatocytes 143 , 145 , 152 and tubular epithelial cells of the kidney, 146 , 147 as well as in infiltrating lymphocytes, often atypical. 141 , 148 , 152 Notably, the detection of HHV-6 in these cells has corresponded to severe necrosis and dysfunction in the related organs.…”

Section: Atypical/unusual Lymphoproliferative Disorders and Lymphocytmentioning

confidence: 99%

Lymphoproliferative Syndromes Associated With Human Herpesvirus-6a and Human Herpesvirus-6b

Eliassen

Krueger

Luppi

et al. 2018

Mediterr J Hematol Infect Dis

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Human herpesvirus 6A and 6B (HHV-6A and HHV-6B) have been noted since their discovery for their T-lymphotropism. Although it has proven difficult to determine the extent to which HHV-6A and HHV-6B are involved in the pathogenesis of many diseases, evidence suggests that primary infection and reactivation of both viruses may induce or contribute to the progression of several lymphoproliferative disorders, ranging from benign to malignant and including infectious mononucleosis-like illness, drug induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS), and nodular sclerosis Hodgkin’s lymphoma. Herein, we discuss the conditions associated with the lymphoproliferative capacity of HHV-6, as well as the potential mechanisms behind them. Continued exploration on this topic may add to our understanding of the interactions between HHV-6 and the immune system and may open the doors to more accurate diagnosis and treatment of certain lymphoproliferative disorders.

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Evidence for human herpesvirus-6B infection of regulatory T-cells in acute systemic lymphadenitis in an immunocompetent adult with the drug reaction with eosinophilia and systemic symptoms syndrome: A case report

Cited by 22 publications

References 22 publications

Bronchoscopic Investigation of Atypical Drug-induced Hypersensitivity Syndrome Showing Viral Lung Involvement

Bronchoscopic Investigation of Atypical Drug-induced Hypersensitivity Syndrome Showing Viral Lung Involvement

Chronic viral infections in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

Lymphoproliferative Syndromes Associated With Human Herpesvirus-6a and Human Herpesvirus-6b

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