Title :

Retrospective Study on the Association of Human Herpesvirus Reactivation with Severe DRESS: A Description of Blood and Skin Reactivations.

Author(s) :

Marcombes, C. [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Ingen-Housz-Oro, S. [Auteur]
Hôpital Henri Mondor
Dezoteux, Frédéric [Auteur]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Staumont, delphine [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Milpied, B. [Auteur]
Service de dermatologie [Bordeaux]
Tetart, F. [Auteur]
Service de Dermatologie [Rouen]
De Prost, N. [Auteur]
Hôpital Henri Mondor
Fourati, S. [Auteur]
Hôpital Henri Mondor
Ortonne, N. [Auteur]
Hôpital Henri Mondor
Kasimir, F. [Auteur]
Julius-Maximilians-Universität Würzburg = University of Würzburg [JMU]
Prusty, B. K. [Auteur]
Julius-Maximilians-Universität Würzburg = University of Würzburg [JMU]
Descamps, V. [Auteur]
AP-HP - Hôpital Bichat - Claude Bernard [Paris]

Journal title :

Journal of the European Academy of Dermatology and Venereology

Abbreviated title :

J Eur Acad Dermatol Venereol

Publication date :

2023-08-27

ISSN :

1468-3083

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a severe adverse event (mortality of 10%). Its pathophysiology involves herpesviruses, particularly HHV-6, but the exact mechanisms are still ...
Show more >Background Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a severe adverse event (mortality of 10%). Its pathophysiology involves herpesviruses, particularly HHV-6, but the exact mechanisms are still poorly understood. Objective To describe severe cases of DRESS and especially their association with herpesvirus reactivation. Methods This study was a multicentre case series conducted between 2007 and 2021 at five University Hospital Centres in France. The study included patients who had severe DRESS, which was defined as death, transfer to the intensive care unit (ICU), or severe damage to internal organs. We excluded patients without blood PCR sample, without a drug formally attributed or with RegiSCAR score < 6. We collected data on severity, causative drug, associated visceral damage and results of viral blood PCRs. HHV-6 reactivation was studied in skin biopsies by detection of small non-coding transcripts (HHV-6 miR-aU14) and a late viral protein (GP82/105). Results Fifty-two patients were included (29 female, median age 62, interquartile range (IQR) [37;72]). Eight patients (15%) died, 13 (27%) were admitted to ICU. Most patients (n = 34; 65%) had multisystem involvement: most frequent was liver (n = 46; 88%), then renal failure (n = 24; 46%). Forty patients (77%) had at least one blood viral reactivation among HHV-6, EBV or CMV, of which 21 (53%) had at least two. Median time of blood HHV-6 reactivation was 24 days (IQR [20;35]). HHV-6 reactivation was demonstrated in 15 out of 20 skin biopsies, with a median time of 11 days [9;17]. Conclusions We confirmed the high rate of HHV-6 reactivation in severe DRESS and demonstrated cutaneous HHV-6 reactivation using small non-coding transcripts (HHV-6 miR-aU14), which preceded viral PCR positivity in blood. These results suggest that HHV-6 reactivation during DRESS may start in skin. Furthermore, search for miR-aU14 in skin biopsy could become a useful diagnostic tool for early detection of HHV-6 reactivation.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-01-11T22:21:19Z
2024-03-08T12:16:06Z