Table 1.
Characteristic of DIHS patients
| Group | Case no. | Age/sex | Culprit drug | Duration between starting of drug and develop of skin eruption | Body temperature (℃) | Lymphadenopathy | Peripheral blood † | ALT † (U/L) | CRP † (mg/dL) | Systemic corticosteroid | Detection of viral DNA in blood (days from onset to initial detection) | Relapsing symptoms or complications over 1 month after the onset | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WBC (/μL) | Eosinophils (/μL) | Atypical lymphocytes (%) | Initiation day | Dose of prednisolone* (mg/kg per day) | Duration (days) | HHV‐6 | EBV | CMV | ||||||||||
| A | 1 | 54/F | Mexiletine | 30 days | >38 | + | 11 800 | 1530 | 3 | 447 | 1.79 | − | – | – | + (25) | − | − | Hepatitis |
| 2 | 48/F | Phenytoin | 2 years | >39 | + | 15 900 | 7550 | 0 | 146 | 2.96 | – | – | – | + (19) | + (33) | − | Fever, skin rash | |
| 3 | 88/F | Carbamazepine | 50 days | >38 | − | 10 100 | 0 | 0 | 139 | 4.98 | – | – | – | + (16) | + (16) | + (37) | No | |
| 4 | 30/M | Carbamazepine | 39 days | >37 | + | 10 600 | 2600 | 8 | 729 | 3.43 | – | – | – | + (21) | − | + (33) | No | |
| 5 | 64/M | Carbamazepine | 24 days | >37 | − | 10 800 | 430 | 3 | 1521 | 1.3 | – | – | – | + (21) | + (15) | − | No | |
| 6 | 76/F | Carbamazepine | 20 days | >39 | − | 10 400 | 5529 | 9 | 158 | 5.25 | – | – | – | + (18) | − | − | Neurogenic bladder dysfunction, renal impairment | |
| 7 | 32/F | DDS | 21 days | >39 | + | 16 000 | 400 | 44 | 272 | 1.24 | – | – | – | − | − | − | No | |
| Average ± SED | 12 229 ± 850 | 1606 ± 634 | 9.6 ± 5.1 | 487 ± 165 | 3.14 ± 0.54 | |||||||||||||
| B | 8 | 33/F | Zonisamide/Phenobarbital | 31/6 days | >39 | + | 28 300 | 1300 | 26 | 1202 | 4.68 | 4 | 1.1 | 42 | + (14) | − | − | Alopecia areata |
| 9 | 24/F | Phenobarbital | 30 days | >40 | + | 15 900 | 742 | 3 | 275 | 3.38 | 3 | 1.0 | 20 | − | +(13) | − | No | |
| 10 | 42/F | Carbamazepine | 48 days | >38 | + | 14 800 | 2550 | 2.5 | 350 | 0.92 | 5 | 1.1 | 25 | − | − | − | No | |
| 11 | 47/M | Vancomycin | 22 days | >39 | + | 55 800 | 2976 | 0.8 | 528 | 3.22 | 2 | 1.0 | 30 | − | + (14) | + (23) | Fever, urticaria | |
| 12 | 54/M | Sulfamethoxazole/trimethoprim | 35 days | >38 | + | 11 800 | 236 | 24 | 1389 | 6.31 | 4 | 1.3 | 22 | − | + (4 ‡ ) | + (14) | Urticaria | |
| 13 | 63/M | Carbamazepine | 34 days | >39 | + | 17 500 | 835 | 9.5 | 162 | 8.08 | 2 | 0.9 → 1. 1 (day 5) | 28 | + (15) | + (19) | + (41) | Pneumocystis pneumonia, skin rash | |
| Average ± SED | 24 017 ± 5713 | 1607 ± 484 | 11.0 ± 3.8 | 651 ± 178 | 4.43 ± 0.87 | 28 ± 7 | ||||||||||||
| C | 14 | 48/F | Carbamazepine | 2 year | >39 | + | 21 800 | 5777 | 1 | 70 | 7.44 | 13 | 1.1 | 120 | + (20) | + (38) | + (59) | CMV gastroenteritis, skin rash |
| 15 | 44/M | Carbamazepine | 29 days | >39 | + | 22 400 | 5710 | 10 | 282 | 6.21 | 9 | 0.4 → 0.8(day 12) | 50 | + (17) | − | − | Fever, skin rash | |
| 16 | 72/M | Phenytoin | 34 days | >39 | + | 15 000 | 264 | 3 | 22 | 2.69 | 4 | 0.5 | 66 | + (15) | + (28) | + (35) | Pneumocystis pneumonia, skin rash | |
| 17 | 60/M | Zonisamide | 3 months | >39 | + | 13 000 | 1430 | 15 | 1655 | 7.88 | 2 | 0.2 → 1.6 (day 18) | 82 | + (23) | +(19 ‡ ) | +(19 ‡ ) | Skin rash | |
| 18 | 73/F | Mexiletine | 23 days | >39 | + | 29 500 | 2011 | 0 | 114 | 5.85 | 6 | 0.6 → 1.0 (day 13) | 25 | + (13) | + (9) | + (27) | Skin rash | |
| 19 | 30/M | Carbamazepine | 30 days | >39 | + | 13 200 | 0 | 1 | 427 | 9.67 | 11 | 0.8 | 43 | − | + (36) | − | Skin rash | |
| 20 | 40/F | Carbamazepine | 40 days | >40 | + | 15 600 | 2960 | 11 | 213 | 2.9 | 7 | 0.5 | 27 | + (13 ‡ ) | − | +(13 ‡ ) | Skin rash | |
| Average ± SED | 18 643 ± 2008 | 2593 ± 777 | 5.9 ± 2.0 | 397 ± 187 | 6.09 ± 0.84 | 65 ± 31 | ||||||||||||
ALT, alanine aminotransferase; CRP, C‐reactive protein; EBV, Epstein–Barr virus; HHV‐5, human herpesvirus 6; SED, standard error of the mean; WBC, white blood cell.
†
Body temperature and the most abnormal laboratory data at acute phase are shown.
‡
Viral DNA was detected from initial serum sample.