Human herpesvirus 6 reactivation in trichloroethylene-exposed workers suffering from generalized skin disorders accompanied by hepatic dysfunction

Hanlin Huang, Michihiro Kamijima, Hailan Wang, Senhua Li, Tetsushi Yoshikawa, Guanchao Lai, Zhenlie Huang, Huifang Liu, Jiabin Chen, Yasuhiro Takeuchi, Tamie Nakajima, Laiyu Li

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Idiosyncratic generalized skin disorders resembling serious drug hypersensitivities have reportedly occurred after occupational exposure to trichloroethylene. However, factors associated with the disorders remain unknown except for trichloroethylene exposure. This study aimed at clarifying whether infectious diseases contributed to the development of rash or hepatitis in patients with trichloroethylene-related generalized skin disorders. Fifty-nine patients consecutively hospitalized between March 2002 and December 2003 and 59 healthy exposed workers selected on an age-matched basis in the patients' factories were enrolled in the study. Information on possible risk factors for rash and hepatitis was collected with structured checklists. Antibody titers were measured for hepatitis A, B and C viruses, Mycoplasma pneumoniae, herpes simplex viruses 1 and 2, Epstein-Barr virus, cytomegalovirus, human herpesvirus 6, measles and rubella virus. Thirty-six cases (59%) showed exfoliative dermatitis, 17 (28%) erythema multiforme, 4 (7%) Stevens-Johnson syndrome, and 4 (7%) toxic epidermal necrolysis. Before the onset of rash, 16 (27%) cases had received medication prescribed for the preceding fever, a main first symptom of the disorders. Marked increases in anti-human herpesvirus 6 IgG titer (≥256), which indicated viral reactivation, were noted in 14 (25%) patients, while no abnormal increase was detected in the controls (p<0.001). Anti-measles IgM titer was positive in 2 (7%) cases but not in the controls (p=0.49). The involvement of other known risk factors of rash or hepatitis was ruled out. These results suggest that part of trichloroethylene-related generalized cutaneous disorders occurring in China and drug-induced hypersensitivity syndrome overlap in terms of human herpesvirus 6 reactivation.

Original languageEnglish
Pages (from-to)417-423
Number of pages7
JournalJournal of Occupational Health
Volume48
Issue number6
DOIs
Publication statusPublished - 01-11-2006

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Human Herpesvirus 6
Trichloroethylene
Exanthema
Hepatitis
Stevens-Johnson Syndrome
Skin
Liver
Drug Hypersensitivity Syndrome
Exfoliative Dermatitis
Rubella virus
Erythema Multiforme
Drug Hypersensitivity
Hepatitis A virus
Mycoplasma pneumoniae
Measles virus
Human Herpesvirus 2
Measles
Human Herpesvirus 1
Occupational Exposure
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All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

Cite this

Huang, Hanlin ; Kamijima, Michihiro ; Wang, Hailan ; Li, Senhua ; Yoshikawa, Tetsushi ; Lai, Guanchao ; Huang, Zhenlie ; Liu, Huifang ; Chen, Jiabin ; Takeuchi, Yasuhiro ; Nakajima, Tamie ; Li, Laiyu. / Human herpesvirus 6 reactivation in trichloroethylene-exposed workers suffering from generalized skin disorders accompanied by hepatic dysfunction. In: Journal of Occupational Health. 2006 ; Vol. 48, No. 6. pp. 417-423.
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abstract = "Idiosyncratic generalized skin disorders resembling serious drug hypersensitivities have reportedly occurred after occupational exposure to trichloroethylene. However, factors associated with the disorders remain unknown except for trichloroethylene exposure. This study aimed at clarifying whether infectious diseases contributed to the development of rash or hepatitis in patients with trichloroethylene-related generalized skin disorders. Fifty-nine patients consecutively hospitalized between March 2002 and December 2003 and 59 healthy exposed workers selected on an age-matched basis in the patients' factories were enrolled in the study. Information on possible risk factors for rash and hepatitis was collected with structured checklists. Antibody titers were measured for hepatitis A, B and C viruses, Mycoplasma pneumoniae, herpes simplex viruses 1 and 2, Epstein-Barr virus, cytomegalovirus, human herpesvirus 6, measles and rubella virus. Thirty-six cases (59{\%}) showed exfoliative dermatitis, 17 (28{\%}) erythema multiforme, 4 (7{\%}) Stevens-Johnson syndrome, and 4 (7{\%}) toxic epidermal necrolysis. Before the onset of rash, 16 (27{\%}) cases had received medication prescribed for the preceding fever, a main first symptom of the disorders. Marked increases in anti-human herpesvirus 6 IgG titer (≥256), which indicated viral reactivation, were noted in 14 (25{\%}) patients, while no abnormal increase was detected in the controls (p<0.001). Anti-measles IgM titer was positive in 2 (7{\%}) cases but not in the controls (p=0.49). The involvement of other known risk factors of rash or hepatitis was ruled out. These results suggest that part of trichloroethylene-related generalized cutaneous disorders occurring in China and drug-induced hypersensitivity syndrome overlap in terms of human herpesvirus 6 reactivation.",
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Human herpesvirus 6 reactivation in trichloroethylene-exposed workers suffering from generalized skin disorders accompanied by hepatic dysfunction. / Huang, Hanlin; Kamijima, Michihiro; Wang, Hailan; Li, Senhua; Yoshikawa, Tetsushi; Lai, Guanchao; Huang, Zhenlie; Liu, Huifang; Chen, Jiabin; Takeuchi, Yasuhiro; Nakajima, Tamie; Li, Laiyu.

In: Journal of Occupational Health, Vol. 48, No. 6, 01.11.2006, p. 417-423.

Research output: Contribution to journalArticle

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AU - Huang, Hanlin

AU - Kamijima, Michihiro

AU - Wang, Hailan

AU - Li, Senhua

AU - Yoshikawa, Tetsushi

AU - Lai, Guanchao

AU - Huang, Zhenlie

AU - Liu, Huifang

AU - Chen, Jiabin

AU - Takeuchi, Yasuhiro

AU - Nakajima, Tamie

AU - Li, Laiyu

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AB - Idiosyncratic generalized skin disorders resembling serious drug hypersensitivities have reportedly occurred after occupational exposure to trichloroethylene. However, factors associated with the disorders remain unknown except for trichloroethylene exposure. This study aimed at clarifying whether infectious diseases contributed to the development of rash or hepatitis in patients with trichloroethylene-related generalized skin disorders. Fifty-nine patients consecutively hospitalized between March 2002 and December 2003 and 59 healthy exposed workers selected on an age-matched basis in the patients' factories were enrolled in the study. Information on possible risk factors for rash and hepatitis was collected with structured checklists. Antibody titers were measured for hepatitis A, B and C viruses, Mycoplasma pneumoniae, herpes simplex viruses 1 and 2, Epstein-Barr virus, cytomegalovirus, human herpesvirus 6, measles and rubella virus. Thirty-six cases (59%) showed exfoliative dermatitis, 17 (28%) erythema multiforme, 4 (7%) Stevens-Johnson syndrome, and 4 (7%) toxic epidermal necrolysis. Before the onset of rash, 16 (27%) cases had received medication prescribed for the preceding fever, a main first symptom of the disorders. Marked increases in anti-human herpesvirus 6 IgG titer (≥256), which indicated viral reactivation, were noted in 14 (25%) patients, while no abnormal increase was detected in the controls (p<0.001). Anti-measles IgM titer was positive in 2 (7%) cases but not in the controls (p=0.49). The involvement of other known risk factors of rash or hepatitis was ruled out. These results suggest that part of trichloroethylene-related generalized cutaneous disorders occurring in China and drug-induced hypersensitivity syndrome overlap in terms of human herpesvirus 6 reactivation.

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