Síndrome de reacción a drogas con eosinofilia y síntomas sistémicos asociado a herpesvirus humano 6. Caso pediátrico tratado con ciclosporina y corticoides / Drug reaction with eosinophilia and systemic symptoms syndrome associated with human herpesvirus 6. A pediatric case treated with cyclosporine and corticosteroids

La reacción a drogas con eosinofilia y síntomas sistémicos es una reacción adversa cutánea rara, potencialmente grave. Puede presentar fiebre, erupción cutánea polimorfa, edema facial y/o linfoadenopatías. La reactivación del virus herpes humano tipo 6 se asocia a un curso más grave y/o prolongado.Un lactante de 22 meses en tratamiento con fenobarbital presentó lesiones eritematopapulares, fiebre, leucocitosis, proteína C reactiva elevada y alteración de pruebas hepáticas. Se realizó biopsia de piel compatible con reacción adversa a drogas. Se trató con corticoides sistémicos e inmunoglobulina intravenosa sin respuesta. La reacción en cadena de la polimerasa para virus herpes humano tipo 6 resultó positiva. Se inició ciclosporina más prednisona, con buena respuesta. Existe poca evidencia del uso de ciclosporina en adultos, cuando los corticoides sistémicos son inefectivos. Este es el primer reporte pediátrico Podría ser una alternativa efectiva o un complemento de los corticosteroides sistémicos cuando no responde a tratamientos convencionales.

Drug reaction with eosinophilia and systemic symptoms is a rare and potentially serious skin adverse reaction, with fever, polymorphous skin rash, facial edema, and/or lymphadenopathy. Reactivation of human herpes virus type 6 has been associated with a more severe and/or prolonged course. A 22-month-old infant under phenobarbital treatment developed erythematous-papular lesions, fever, leukocytosis, elevated C-reactive protein, and abnormal liver tests. The skin biopsy was compatible with an adverse drug reaction. Treatment with systemic corticosteroids and intravenous immunoglobulin had no response. Polymerase chain reaction for human herpesvirus type 6 was positive, and cyclosporine plus prednisone was started with a good response. There is little evidence for the use of cyclosporine in adults when systemic corticosteroids are ineffective. This is the first report of pediatric drug reaction with eosinophilia and systemic symptoms treated with cyclosporine, which could be an effective alternative or an adjunct to systemic corticosteroid therapy unresponsive to conventional treatments.

Infección por Herpes virus Humano tipo 6 relacionado con manifestaciones dermatológicas y fatiga crónica: serie de casos / Human Herpesvirus type 6 infection related to dermatological manifestations and chronic fatigue: case series

Resumen Introducción: Las manifestaciones clínicas más frecuentes causadas por el Herpes Virus Humano Tipo 6 (HHV-6) ocurren en niños menores de 2 años, presentan lesiones en piel tipo roséola o exantema súbito. En adultos, las manifestaciones clínicas relacionadas a HHV-6 son muy variables, y pueden sobreponerse con otras afecciones. Objetivo: Presentar una serie de casos de pacientes diagnosticados con infección activa por HHV-6, quienes mostraban manifestaciones neurológicas, dermatológicas y de fatiga crónica. Materiales y métodos: Se realizó análisis de historias clínicas de 6 pacientes que fueron diagnosticados con infección activa por HHV-6, a través de métodos moleculares. Resultados: Se reportan 6 pacientes que fueron diagnosticados con infección activa por HHV-6 mediante métodos moleculares, quienes presentaron manifestaciones clínicas comunes tales como: fiebre, cefalea, depresión, decaimiento, pérdida de memoria y concentración, dolor fibromuscular, dolor poliarticular, sueño no reparador, exantema, nevus rubí, liquen plano y parestesias. Conclusiones: A través de esta serie de casos se espera resaltar la importancia de identificar la infección activa por HHV-6 a través de métodos moleculares, y sensibilizar a la comunidad médica sobre el papel que juega el virus en la evolución de diversas patologías.

Abstract Introduction: The most frequent clinical manifestations of Human Herpesvirus 6 (HHV-6) in children under 2 years of age are roseola-like skin lesions and sudden rash. In adults, the clinical manifestations associated with HHV-6 are highly variable and can overlap with other conditions. Objective: To present a case series of patients diagnosed with active HHV-6 infection, who showed neurological, dermatological and chronic fatigue manifestations. Materials and methods: An analysis of medical records of 6 patients who were diagnosed with active HHV-6 infection through molecular methods was performed. Results: 6 patients were diagnosed with active HHV-6 infection using molecular methods, who had common clinical manifestations such as fever, headache, depression, tiredness, loss of memory and concentration, fibromuscular pain, polyarticular pain, nonrestorative sleep, rash, ruby nevus, lichen planus and paresthesia. Conclusions: This case series highlights the importance of identifying active HHV-6 infection through molecular methods and creating awareness in the medical community of the role that the virus plays on the development of diverse pathologies.

Serum levels of matrix metalloproteinase-2, -9, and vitamin D in patients with multiple sclerosis with or without herpesvirus-6 seropositivity

ABSTRACT In recent years, extreme attention has been focused on the role of human herpesvirus-6 (HHV-6) in multiple sclerosis (MS) pathogenesis. However, the pathogenesis of MS associated with HHV-6 infection remains unknown. In this study, we measured the serum levels of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), and vitamin D levels in MS patients with HHV-6 infection and MS patients without HHV-6 infection. Five hundred sixty (including 300 females and 260 males) MS patients along with 560 healthy subjects were analyzed for HHV-6 seropositivity using enzyme-linked immunosorbent assay (ELISA). Subsequently, we measured the serum levels of MMP-2, MMP-9, and vitamin D levels in MS patients with HHV-6 infection and MS patients without HHV-6 infection by ELISA. About 90.7% of MS patients (508/560) were seropositive for HHV-6, while 82.3% (461/560) of healthy subjects were seropositive for this virus (p = 0.001). Moreover, there was a significant increase in the levels of MMP-2, MMP-9, and lower vitamin D in the serum samples of MS patients when compared with healthy subjects. Additionally, we demonstrated that the MMP-9 levels in seropositive MS patients were significantly higher than seronegative MS patients (p = 0.001). Finally, our results demonstrated that the mean of expanded disability status scale (EDSS) in seropositive MS patients was significantly higher in comparison to seronegative MS patients (p < 0.05). In conclusion, we suggest that the HHV-6 infection may play a role in MS pathogenesis.

Research progress on human herpesvirus 6 infection after liver transplantation / 器官移植

Human herpesvirus 6 (HHV-6) may establish lifetime latency after initial invasion of the host, and liver transplant recipients may experience reactivation of latent infection during immunosuppression. HHV-6 infection in liver transplant recipients could lead to fever, hepatitis, encephalitis and graft dysfunction, and indirectly increases the risk of progression of liver fibrosis due to cytomegalovirus (CMV), hepatitis C virus (HCV) infection. At present, the pathogenesis of HHV-6 infection after liver transplantation has not been systematically elucidated, and effective prevention and treatment strategies are still lacking. This article provided a review for the research progress on the pathogenesis, risk factors, diagnosis and treatment of HHV-6 infection after liver transplantation.

Human herpesvirus 6A active infection in patients with autoimmune Hashimoto's thyroiditis

ABSTRACT Background: Hypothyroidism due to Hashimoto's thyroiditis (HT) is the commonest autoimmune endocrine illness in which antibodies against thyroid organ result in inflammation. The disease has a complex etiology that involves genetic and environmental influences. Viral infections may be involved in triggering of the disease as their molecular mimicry enhance autoimmune responses. Human herpesvirus-6 (HHV-6) is recognized for its contribution to some autoimmune diseases. Objective: In the current study, the prevalence of HHV-6 active infection in patients with HT and with non-autoimmune thyroid disorders were compared with patients with euthyroidism. In addition, a correlation between presence of HHV-6 infections and HT was investigated. Methods: A total of 151 patients with clinically and laboratory confirmed HT, 59 patients with non-autoimmune thyroid disorders, and 32 patients with normal thyroid function were included in the study. For further confirmation of HT disease, all the precipitants were tested for anti-thyroid peroxidase (TPO), and anti-thyroglobulin (TG) antibodies. For detection of both HHV-6 types A and B, nested PCR and restriction enzyme digestion were used. HHV-6 DNA positive samples were further investigated by DNA sequencing analysis. Results: HHV-6A DNA was found in serum sample of 57 out of 151 patients (38%) with HT, which was significantly more often than in patients with non-autoimmune thyroid disorders (p = 0.001). However, HHV-6 DNA was not detected in serum samples of euthyroid subjects. Conclusions: The results support a possible role for active HHV-6A infection, demonstrated by the presence of HHV-6 DNA in sera, in the development of HT.

Encefalopatía por virus herpes 6 como complicación de exantema súbito / Encephalopathy due to human herpesvirus 6 infection as exanthema subitum complication

La principal manifestación clínica del herpesvirus 6 es el exantema súbito (también conocido como roséola o sexta enfermedad) y el síndrome febril. Las manifestaciones en el sistema nervioso central no son infrecuentes en la infección por herpesvirus 6, y su fisiopatología no está esclarecida, pero precisan diagnóstico y tratamiento temprano para evitar secuelas potencialmente graves. Se presenta el caso de una niña inmunocompetente de 2 años con cuadro de encefalitis como complicación de infección por herpesvirus 6. Se destaca la importancia del diagnóstico oportuno a fin de instaurar un adecuado tratamiento y seguimiento para evitar complicaciones secundarias a la afectación del sistema nervioso central.

The main clinical manifestation of human herpesvirus 6 is exanthema subitum (also known as roseola infantum) and febrile syndrome. Central nervous system manifestations are not unusual in herpesvirus 6 infection, and even though the pathophysiology is not clear, they need to be early diagnosed and treated in order to avoid potentially serious damage. We present the case of an immunocompetent 2-year-old girl with encephalitis as a complication of herpesvirus 6 infection. We want to emphasize the significance of an early diagnosis and treatment in order to prevent further complications due to the central nervous system extension.

Association of occupational medicamentosa-like dermatitis induced by trichloroethylene and infection with human herpesvirus 6 and cytomegalovirus / 中国职业医学

OBJECTIVE: To explore the potential association between occupational medicamentosa-like dermatitis induced by trichloroethylene( OMDT) and past infection,reactivation and recent infection of human herpesvirus 6( HHV6) and human cytomegalovirus( HCMV). METHODS: Twenty OMDT patients were recruited as case group by using judgment sampling method. Twenty healthy workers occupationally exposed to trichloroethylene for more than half a year were randomly selected as exposure group. Twenty healthy people with no exposure history to trichloroethylene were randomly selected as control group. The enzyme linked immunosorbent assay was used to qualitatively determine the titer of HHV6 and HCMV immunoglobulin( Ig) G,Ig M antibodies from serum samples of these subjects. The polymerase chain reaction was used to qualitatively detect HHV6 and HCMV DNA from whole blood DNA samples of these subjects. The differences of previous infection rate,reactivation rate and recent infection rate of HHV6 and HCMV among these three groups of patients with different clinical types of OMDT were analyzed. RESULTS: The prevalence of HHV6 and HCMV infection in the case group was higher than that in the control group,and the difference was statistically significant( 65. 5% vs 20. 0%,75. 0% vs15. 0%,P < 0. 017). The reactivation rate of HHV6 and HCMV in the case group was higher than that in the control group,but the difference was not statistically significant( P > 0. 017). The recent infection rate of HHV6 and HCMV in the case group was not significantly different from that in the control group( P > 0. 017). There was no significant difference in the past infection rate,reactivation rate and recent infection rate of HHV6 and HCMV between the exposure group and the control group( P > 0. 05),meanwhile in different clinical types of OMDT patients( P > 0. 05). CONCLUSION: OMDT may be associated with past infection of HHV6 and HCMV.

Predicting Factors of Roseola Infantum Infected with Human Herpesvirus 6 from Urinary Tract Infection

PURPOSE: The aim of this study was to compare the clinical and laboratory features of infants with roseola infantum due to human herpesvirus 6 (HHV6) infection and those with urinary tract infection (UTI). METHODS: We retrospectively reviewed the medical records of children who were hospitalized at Cheil General Hospital and Women's Health Care Center, College of Medicine, Dankook University, and diagnosed as having HHV6 infection or UTI. RESULTS: Among the infants admitted between September 2014 and May 2016, 92 (male, 45 and female, 47) were included in the study and divided into a HHV6 infection group (n=50) and a UTI group (n=42). The relative risk of UTI compared with that of HHV6 infection increased with pyuria (P<0.001), increased with leukocytosis (mean white blood cell [WBC] count, 15,048±5,756/mm³ vs 87,916±54,056/mm³; P<0.001), increased with C-reactive protein (CRP) level (4.89±4.85 mg/dL vs 1.04±1.76 mg/dL; P<0.001), and younger age (6.3±3.2 months vs 18.3±12.6 months; P<0.001). The relative risk of HHV6 infection compared with that of UTI increased with fever duration (4.3±1.7 days vs 2.8±1.7 days; P<0.001) and decreased with platelet (PLT) count (373±94×10³/mm³ vs 229±90×10³/mm³; P<0.001). No significant differences were found between the HHV6 groups according to the presence or absence of pyuria. CONCLUSION: Pyuria, age, fever duration, WBC count, CRP level, and PLT count were the differentiating factors of HHV6 infection from UTI. However, sterile pyuria can occur in children with HHV6 infection. In the presence of pyuria, CRP level and PLT count were the strong predictors of UTI compared with HHV6.

Optimisation of a quantitative polymerase chain reaction-based strategy for the detection and quantification of human herpesvirus 6 DNA in patients undergoing allogeneic haematopoietic stem cell transplantation

Human herpesvirus 6 (HHV-6) may cause severe complications after haematopoietic stem cell transplantation (HSCT). Monitoring this virus and providing precise, rapid and early diagnosis of related clinical diseases, constitute essential measures to improve outcomes. A prospective survey on the incidence and clinical features of HHV-6 infections after HSCT has not yet been conducted in Brazilian patients and the impact of this infection on HSCT outcome remains unclear. A rapid test based on real-time quantitative polymerase chain reaction (qPCR) has been optimised to screen and quantify clinical samples for HHV-6. The detection step was based on reaction with TaqMan® hydrolysis probes. A set of previously described primers and probes have been tested to evaluate efficiency, sensitivity and reproducibility. The target efficiency range was 91.4% with linearity ranging from 10-106 copies/reaction and a limit of detection of five copies/reaction or 250 copies/mL of plasma. The qPCR assay developed in the present study was simple, rapid and sensitive, allowing the detection of a wide range of HHV-6 loads. In conclusion, this test may be useful as a practical tool to help elucidate the clinical relevance of HHV-6 infection and reactivation in different scenarios and to determine the need for surveillance.

Drug-induced hypersensitivity syndrome with human herpesvirus-6 reactivation.

A 45-year-old man, on carbamazepine for the past 3 months, was referred as a case of atypical measles. On examination, he had high-grade fever, generalized itchy rash, cough, vomiting and jaundice. A provisional diagnosis of drug hypersensitivity syndrome to carbamazepine was made with a differential diagnosis of viral exanthema with systemic complications. Laboratory investigations revealed leukocytosis with eosnophilia and elevated liver enzymes. Real-time multiplex polymerase chain reaction (PCR) on throat swab and blood was suggestive of human herpesvirus-6 (HHV-6). Measles was ruled out by PCR and serology. The diagnosis of drug-induced hypersensitivity syndrome (DIHS) was confirmed, which could explain all the features manifested by the patient. HHV-6 infects almost all humans by age 2 years. It infects and replicates in CD4 T lymphocytes and establishes latency in human peripheral blood monocytes or macrophages and early bone marrow progenitors. In DIHS, allergic reaction to the causative drug stimulates T cells, which leads to reactivation of the herpesvirus genome. DIHS is treated by withdrawal of the culprit drug and administration of systemic steroids. Our patient responded well to steroids and HHV-6 was negative on repeat real-time multiplex PCR at the end of treatment.

Recent progress of elucidating the mechanisms of drug hypersensitivity

Recent technical approaches to investigating drug hypersensitivity have provided a great deal of information to solve the mechanisms that remain poorly understood. First, immunological investigations and in silico analysis have revealed that a novel interaction between T cells and antigen-presenting cells, namely the pharmacological interaction concept, is involved in drug recognition and the hapten theory. Second, progress in immunology has provided a new concept of CD4+ T cell subsets. Th17 cells have proven to be a critical player in acute generalized exanthematous pustulosis. Our recent findings suggest that this subset might contribute to the pathogenesis of Stevens-Johnson syndrome/toxic epidermal necrolysis. Third, alarmins, molecules associated with innate immunity, are also associated with exaggeration and the persistence of severe drug hypersensitivity. The latest innovative techniques are providing a new landscape to examine drug hypersensitivity.

Detection of Human Herpesvirus-6 (HHV-6) in Cerebrospinal Fluid of a Patient with Fatal Status Epilepticus

Human herpesvirus-6 (HHV-6) often causes mild illnesses, but is rarely associated with encephalitis or other fatal neurological conditions. We report a girl who died of a intractable status epilepticus from HHV-6. A 14-month-old girl presented with focal motor seizures in right extremities evolving to generalized convulsive status epilepticus. She had a history of mild diarrhea for 4 days and high fever for 2 days. Although she was treated with lorazepam, phenytoin, phenobarbital, and continuous midazolam infusion, generalized seizures continued for 3 hours after arrival. She became seizure free, but remained unconscious and ended up to death at the 44 days of hospitalization. The CSF HHV-6 DNA PCR turned out to be positive.

Diagnosis of human herpesvirus 6B primary infection by polymerase chain reaction in young children with exanthematic disease / Diagnóstico de infecção primária pelo herpesvírus humano tipo 6B através da técnica de reação em cadeia da polimerase em crianças com doença exantemática

INTRODUCTION: Exanthem subitum is a classical rash disease of early childhood caused by human herpesvirus 6B (HHV-6B). However, the rash is frequently misdiagnosed as that of either measles or rubella. METHODS: In this study, a nested multiplex polymerase chain reaction (PCR) was used to diagnose HHV-6B primary infection, differentiate it from infections caused by HHV-6A and compare it to antibody avidity tests. The samples were separated into case group and control group according to the results of the indirect immunofluorescence assay (IFA) technique. RESULTS: From the saliva samples analyzed, HHV-6A DNA was detected in 3.2 percent of the case group and in 2.6 percent of the control group. Regarding HHV-6B, PCR detected viral DNA in 4.8 percent of the case group and in 1.3 percent of the control group. Among the serum samples studied, a frequency of 1.7 percent was determined for HHV-6A in the case group and 1.2 percent in the control group. PCR did not detect HHV-6B DNA in serum samples. The sensitivity and specificity of the PCR technique ranged from 0 percent to 4.8 percent and 97.5 percent to 100 percent, respectively, compared to IFA. CONCLUSIONS: The PCR technique was not suitable for diagnosing primary infection by HHV-6B in children with exanthematic disease and should not substitute the IFA.

INTRODUÇÃO: O exantema súbito é uma doença comum durante a infância e pode ser causada pela infecção por herpesvirus humano tipo 6B (HHV-6B). No entanto, a erupção cutânea característica dessa doença, é frequentemente confundida com outras viroses como sarampo ou rubéola. MÉTODOS: Foi utilizada a técnica de reação em cadeia da polimerase (PCR) no formato nested multiplex para o diagnóstico de infecção primária por HHV-6B, diferenciação entre as infecções causadas pelo HHV-6A e comparação com testes de avidez de anticorpos. As amostras foram separadas em grupo caso e grupo controle, de acordo com os resultados do teste de imunofluorescência indireta (IFA). RESULTADOS: Nas amostras de saliva analisadas, o DNA do HHV-6A foi detectado em 3,2 por cento no grupo caso e em 2,6 por cento das amostras do grupo controle. Em relação ao HHV-6B, o DNA viral foi observado em 4,8 por cento no grupo caso e em 1,3 por cento no grupo controle. Após a realização da PCR nas amostras de soro, o DNA do HHV-6A foi detectado em 1,7 por cento no grupo caso e em 1,2 por cento no grupo controle, enquanto o DNA do HHV-6B não foi detectado. A sensibilidade e a especificidade da técnica de PCR variaram de 0 por cento a 4,8 por cento e de 97,5 por cento a 100 por cento, respectivamente, quando comparado com a IFA. CONCLUSÕES: A técnica de PCR não se mostrou adequada para o diagnóstico de infecção primária pelo HHV-6B em crianças com doença exantemática e não deve substituir a IFA.

Limbic Encephalitis Caused by Human Herpesvirus-6 Infection in Allogenic Hematopoietic Stem Cell Transplantation Patient

No abstract available.

Detection of HHV6 and EBV in histiocytic necrotizing lymphadenitis / 소아과

PURPOSE: Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis (HNL), is a self-limited disease characterized by cervical lymphadenopathy and fever. The etiology of KFD remains unknown; however, the self-limiting nature of HNL suggests the cause of this disease could be viral infection. For this reason, several viruses have been evaluated as possible etiologies of HNL, including Epstein-Barr virus (EBV), human herpesvirus 6 (HHV6), human herpesvirus 8 (HHV8), and cytomegalovirus (CMV). The aim of this study was to examine the relationship of EBV and HHV6 to HNL. METHODS: Data pertaining to 51 cases with biopsy-confirmed HNL were collected between January 1999 and December 2005, from the Department of Pathology, College of Medicine, Pusan National University, Busan, Korea. The clinical records-including data regarding age, gender, duration of fever, and lymph node involvementwere reviewed retrospectively. The in situ hybridization (ISH) assay was performed by EBER PNA probe (Dako, Capinteria, CA, USA), and immunohistochemistry testing was performed with anti-HHV type 6 monoclonal antibodies (Chemicon, Temecula, CA, USA). RESULTS: The HNL patients in this study were 24 males and 27 females, ranging in age from seven to 61 years (median: 25.9). ISH for EBV was positive in 8/51 (15.7%) biopsies, and immunohistochemistry for HHV6 was positive in 15/51 (29.4%) biopsies. Serologic analysis of EBV IgM was performed in 23 cases; only one patient was positive for EBV IgM and EBV ISH. CONCLUSION: Our study could not provide supportive evidence of a viral pathogenesis for HNL; therefore, cases of HNL may not have a dominant viral cause. However, some rare exceptional cases may have been caused by viral infection.

Detection of HHV6 and EBV in histiocytic necrotizing lymphadenitis / 소아과

PURPOSE: Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis (HNL), is a self-limited disease characterized by cervical lymphadenopathy and fever. The etiology of KFD remains unknown; however, the self-limiting nature of HNL suggests the cause of this disease could be viral infection. For this reason, several viruses have been evaluated as possible etiologies of HNL, including Epstein-Barr virus (EBV), human herpesvirus 6 (HHV6), human herpesvirus 8 (HHV8), and cytomegalovirus (CMV). The aim of this study was to examine the relationship of EBV and HHV6 to HNL. METHODS: Data pertaining to 51 cases with biopsy-confirmed HNL were collected between January 1999 and December 2005, from the Department of Pathology, College of Medicine, Pusan National University, Busan, Korea. The clinical records-including data regarding age, gender, duration of fever, and lymph node involvementwere reviewed retrospectively. The in situ hybridization (ISH) assay was performed by EBER PNA probe (Dako, Capinteria, CA, USA), and immunohistochemistry testing was performed with anti-HHV type 6 monoclonal antibodies (Chemicon, Temecula, CA, USA). RESULTS: The HNL patients in this study were 24 males and 27 females, ranging in age from seven to 61 years (median: 25.9). ISH for EBV was positive in 8/51 (15.7%) biopsies, and immunohistochemistry for HHV6 was positive in 15/51 (29.4%) biopsies. Serologic analysis of EBV IgM was performed in 23 cases; only one patient was positive for EBV IgM and EBV ISH. CONCLUSION: Our study could not provide supportive evidence of a viral pathogenesis for HNL; therefore, cases of HNL may not have a dominant viral cause. However, some rare exceptional cases may have been caused by viral infection.

Infecciones congénitas poco habituales de transmisión vertical / Less frequent causes of vertical infections

El objetivo es el de efectuar una revisión de aquellos padecimientos de baja frecuencia que son adquiridos por el neonato a través de la vía transplacentaria, con la finalidad de alertar al médico pediatra sobre su existencia, el probable incremento de algunos de ellos, y en forma breve exponer algunos de sus elementos clínicos más distintivos, como es el caso de los herpesvirus 6 y 7, así como 1 y 2; dengue, papilomavirus, Coxsackie virus, Plasmodium, Leishmania, Mycobacterium tuberculosis, Candida y Treponema pallidum. En función de su conocida frecuencia de transmisión, se anota al final el número de mujeres que las presentaron en México en el año 2004, con la finalidad de sensibilizar al médico para que se investigue con mayor intencionalidad su presencia en el neonato.

The objective of this review is to list some of the important, albeit less frequent, causes of vertical infections in the newborn infant in order to alert pediatricians and other physicians that care for children on their existence. A brief summary of the most salient features of the following diseases is provided: herpes-virus 6 and 7 as well as 1 and 2; dengue, papillomavirus, coxsackie virus, Plasmodium, Leishmania, Mycobacterium tuberculosis, Candida and Treponema pallidum. Based on its well-known transmission frequency, the number of women who presented/displayed them in Mexico in 2004 is presented.

Impairment of lymphoproliferative response to human herpesvirus-6 in oral squamous cell carcinoma patients / 基础医学与临床

Objective To study the lymphoproliferative responses to HHV-6(Human Herpesvirus-6,HHV-6)among patients with oral squamous cell carcinoma,and to discuss the role of HHV-6 in the pathogenesis of oral squamous cell carcinoma.Methods IgG antibody to HHV-6 in plasma was identified by indirect immunofluorescence(IIF).Immuno-magnetic beads were used to prepare CD4+ T cells and CD8+ T cells.The proliferation of CD4+ T cells,CD8+ T cells and PBMCs stimulated with HHV-6 or anti-CD3 antibodies was measured by 3H-thymidine uptake.The percentage of CD4+ C25+ Treg cells(Regulatory T cell,Treg)within the peripheral blood CD4+ T cell compartment was analyzed by flow cytometry.Results Significantly higher proportion of patients with oral squamous cell carcinoma had IgG antibody to HHV-6(8/8) in plasma as compared with those in control subjects(12/20);The proliferative responses of PBMCs and CD4+ T cells from patients with oral squamous cell carcinoma to HHV-6 were significantly decreased as compared to those from HHV-6-infected and healthy individuals(P

HHV-6 Reactivation and Fatigue / 日本補完代替医療学会誌

Human herpesvirus (HHV)-6 and HHV-7 establish life-long latency, a hallmark of herpesviruses, reactivate frequently, and are shed in saliva. In the study on the latency and reactivation of HHV-6, we have identified the association between HHV-6 reactivation and the work-induced fatigue in healthy adults. This finding suggests that the HHV-6 reactivation can be an objective biomarker for fatigue.<br>

A Clinical Observation of Drug Hypersensitivity Syndrome and Serologic and Molecular Genetic Analyses of Human Herpesvirus-6 Reactivation / 대한피부과학회지

BACKGROUND: Drug hypersensitivity syndrome (DHS) is a life-threatening reaction that appears after prolonged exposure to certain drugs. Unlike usual drug eruptions, DHS typically represents protracted a clinical course, slow resolution and a higher mortality rate. Recently, several studies have provided evidence to show that the reactivation of human herpesvirus-6 (HHV-6) is implicated in the pathogenesis of DHS. Until now, the study of the relationship of HHV-6 with DHS has rarely been presented in Korea. OBJECTIVE: We performed this study in order to determine the possibility of reactivation of HHV-6 in patients with DHS. METHODS: A clinical survey was performed retrospectively using the available medical records of 8 DHS cases. Concurrently, the histopathologic, serologic and molecular genetic analyses of the preserved specimens of the DHS patients were conducted, and the results were compared with 3 cases of another type of drug eruption. RESULTS: 1. Mean time of onset of clinical disease following the institution of a new drug was 21.8 days. Time from appearance of first skin lesion to the initiation of therapy (time to treat) was 6.1 days. The most common offending drugs were allopurinol (37.5%) and anti-convulsants (50%), including lamotrigine. The clinical outcome was as follows; recovery in 7 patients and transfer in one patient. 2. The clinical features of patients with DHS were as follows; widespread skin rash (100%), histopathologic findings compatible with drug hypersensitivity (100%), toxic hepatitis (100%), cholestatic injuries (37.5%), renal dysfunction (37.5%), drug fever (100%), leukocytosis (100%), peripheral eosinophilia (100%), lymphadenopathy (62.5%), and atypical lymphoid cells on a peripheral blood smear (62.5%). 3. Anti-HHV-6 IgM antibodies were detected in 2 patients (25%). Reactivation of HHV-6, as judged by a greater than 4-fold increase in anti-HHV-6 IgG titers, was detected in 5 cases (62.5%) of serum samples obtained 3 weeks after onset. 4. HHV-6B genome was detected by polymerase chain reaction (PCR) in 3 patients (37.5%) in the serum samples obtained 2 weeks after onset. At the second weeks, it was detected in the skin lesions of 4 patients (50%) and in the normal skin specimen of one case (12.5%). In one case of a patient without DHS, HHV-6B DNA was found by PCR in the serum sample at the second weeks. CONCLUSION: Several cases of DHS in Korea were associated with the reactivation of HHV-6. Accordingly, HHV-6 reactivation seems to play a potential role in the development of DHS in susceptible patients.