{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T17:28:14Z","timestamp":1748021294803,"version":"3.40.5"},"reference-count":13,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T00:00:00Z","timestamp":1651449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Drug\u2010induced hypersensitivity syndrome (DIHS)\/drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe drug adverse reaction with skin eruption and visceral organ involvement. The characteristic clinical features of DIHS\/DRESS are reactivation of human herpesviruses (HHV) and the development of autoimmune diseases, but their pathogenesis and associations are not yet understood. Here, we report a 66\u2010year\u2010old man who presented with fever, generalized erythema, diffuse lymphadenopathy, and diarrhea after 3\u2009weeks of treatment with zonisamide. Reactivation of HHV\u20106 and cytomegalovirus (CMV) was detected during the clinical course. The patient was diagnosed with DIHS\/DRESS and treated with systemic prednisolone, i.v. immunoglobulin therapy, and ganciclovir. However, severe enterocolitis persisted for 6\u00a0months. A series of examinations revealed features of both CMV enterocolitis, as indicated by identification of a few CMV\u2010positive cells on immunohistochemical analysis, and graft\u2010versus\u2010host disease (GVHD)\u2010like enterocolitis indicated by orange\u2010peel appearance on endoscopic examination and histopathological loss of goblet cells. Intractable enterocolitis continued and the patient finally died of pneumonia. An autoimmune predisposition in DIHS\/DRESS patients in combination with CMV reactivation was considered to trigger the severe enterocolitis of this case that showed GVHD\u2010like features of the gastrointestinal tract. GVHD\u2010like organ damage is a pathological condition rarely observed in DIHS\/DRESS but should be recognized as one of the most severe complications of the disease.<\/jats:p>","DOI":"10.1111\/1346-8138.16415","type":"journal-article","created":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T06:48:52Z","timestamp":1651560532000},"page":"796-799","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Severe graft\u2010versus\u2010host disease\u2010like enterocolitis accompanied with cytomegalovirus\u2010reactivation in drug\u2010induced hypersensitivity syndrome\/drug reaction with eosinophilia and systemic symptoms"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2738-1651","authenticated-orcid":false,"given":"Saeko","family":"Takamiyagi","sequence":"first","affiliation":[{"name":"Department of Dermatology Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4022-8950","authenticated-orcid":false,"given":"Hisato","family":"Iriki","sequence":"additional","affiliation":[{"name":"Department of Dermatology Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiko","family":"Asahina","sequence":"additional","affiliation":[{"name":"Department of Dermatology Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1267-4585","authenticated-orcid":false,"given":"Yuki","family":"Furuichi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeru","family":"Funakoshi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masataka","family":"Ichikawa","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yohei","family":"Mikami","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajime","family":"Okita","sequence":"additional","affiliation":[{"name":"Division of Diagnostic Pathology Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomo","family":"Sakiyama","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Tachikawa Hospital Federation of National Public Service Personnel Mutual Aid Associations  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toyoko","family":"Inazumi","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Tachikawa Hospital Federation of National Public Service Personnel Mutual Aid Associations  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Amagai","sequence":"additional","affiliation":[{"name":"Department of Dermatology Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6768-8821","authenticated-orcid":false,"given":"Hayato","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Keio University School of Medicine  Tokyo 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