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

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 th...

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Bibliographic Details
Published in:Internal Medicine 2016/09/15, Vol.55(18), pp.2691-2696
Main Authors: Hase, Isano, Arakawa, Hiroaki, Sakuma, Hideo, Kaneko, Fumio, Watanabe, Yuzuru, Fujiu, Koichi, Miyamoto, Hideaki, Ishii, Yoshiki
Format: Article
Language:English
Subjects:
bronchus
Carbamazepine - adverse effects
CD8+ T lymphocyte
Cytomegalovirus - immunology
Drug Hypersensitivity Syndrome - physiopathology
drug-induced hypersensitivity syndrome (DIHS)
Herpesviridae
Humans
lung
Lung Diseases - virology
Male
Middle Aged
reactivation of virus
Virus Activation - drug effects
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Description
Summary: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.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.55.6347