Altered T cell and monocyte subsets in prolonged immune reconstitution inflammatory syndrome related with DRESS (drug reaction with eosinophilia and systemic symptoms)
Asia Pacific Allergy
; (4): 2-2020.
Article
em En
| WPRIM
| ID: wpr-785463
Biblioteca responsável:
WPRO
ABSTRACT
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe cutaneous adverse reaction involving various internal organs. Flare-ups after recovery from the initial presentation of DRESS are caused by relapse of drug-induced T-cell-mediated reactions. However, the specific underlying mechanism is unclear. Here, we report a case of a 60-year-old man with allopurinol-induced DRESS who suffered recurrent episodes of generalized rash with eosinophilia, which mimicked immune reconstitution inflammatory syndrome. Analysis of immunological profiles revealed that the percentages of T lymphocytes and regulatory T cells in the patient with DRESS were higher than those in healthy controls. In addition, there was a notable change in the subtype of monocytes in the patient with DRESS; the percentage of nonclassical monocytes increased, whereas that of classical monocytes decreased. Upon viral infection, nonclassical monocytes exhibited strong pro-inflammatory properties that skewed the immune response toward a Th2 profile, which was associated with persistent flare-ups of DRESS. Taken together, the results increase our understanding of the pathogenesis of DRESS as they suggest that expansion of nonclassical monocytes and Th2 cells drives disease pathogenesis.
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Texto completo:
1
Índice:
WPRIM
Assunto principal:
Recidiva
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Monócitos
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Linfócitos T
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Alopurinol
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Linfócitos T Reguladores
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Células Th2
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Eosinofilia
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Exantema
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Síndrome Inflamatória da Reconstituição Imune
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Síndrome de Hipersensibilidade a Medicamentos
Tipo de estudo:
Diagnostic_studies
Limite:
Humans
Idioma:
En
Revista:
Asia Pacific Allergy
Ano de publicação:
2020
Tipo de documento:
Article