CMV complications in DIHS/DRESS: Importance of routine monitoring and early therapeutic intervention.

IF 3.7 4区 医学 Q1 DERMATOLOGY Clinical and Experimental Dermatology Pub Date : 2024-09-02 DOI:10.1093/ced/llae372
Shingo Takei, Ryota Hayashi, Natsumi Hama, Riichiro Abe
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Abstract

The fatal outcomes in DIHS/DRESS are reported to be associated with CMV reactivation. However, CMV reactivation is also observed not only in DIHS/DRESS but also in other diseases when high doses of corticosteroids are administered. Currently, it is difficult to distinguish whether CMV reactivation in DIHS/DRESS is caused by steroid-induced immunosuppression or the pathology of DIHS/DRESS. In this study, we describe the characteristic of CMV reactivation in patients with DIHS/DRESS (n=22) by comparing the frequency of reactivation and its complication with those with pemphigus vulgaris (PV) (n=21) treated with high dose of corticosteroids. The frequency of CMV reactivation showed no difference between DIHS/DRESS and PV. On the other hand, the frequency of CMV complication was higher in DIHS than PV. Our data shows the importance of monitoring the CMV complication while CMV reactivation is not unique consequence of DIHS/DRESS compared to diseases treated with high dose of corticosteroids.

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DIHS/DRESS 中的 CMV 并发症:常规监测和早期治疗干预的重要性。
据报道,DIHS/DRESS 的致命后果与 CMV 再激活有关。然而,不仅在DIHS/DRESS中观察到CMV再激活,在其他疾病中使用大剂量皮质类固醇时也观察到CMV再激活。目前,很难区分 DIHS/DRESS 中的 CMV 再激活是由类固醇诱导的免疫抑制引起的,还是由 DIHS/DRESS 的病理变化引起的。在本研究中,我们通过比较 DIHS/DRESS 患者(22 人)与接受大剂量皮质类固醇治疗的寻常天疱疮(PV)患者(21 人)的 CMV 再激活频率及其并发症,描述了 CMV 再激活的特征。结果显示,DIHS/DRESS 和寻常型天疱疮患者的 CMV 再激活频率没有差异。另一方面,DIHS 的 CMV 并发症发生率高于 PV。我们的数据显示了监测CMV并发症的重要性,而与使用大剂量皮质类固醇治疗的疾病相比,CMV再激活并非DIHS/DRESS的独特后果。
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来源期刊
CiteScore
3.20
自引率
2.40%
发文量
389
审稿时长
3-8 weeks
期刊介绍: Clinical and Experimental Dermatology (CED) is a unique provider of relevant and educational material for practising clinicians and dermatological researchers. We support continuing professional development (CPD) of dermatology specialists to advance the understanding, management and treatment of skin disease in order to improve patient outcomes.
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