A Case of Drug-induced Hypersensitivity Syndrome (DIHS) with Fulminant Type 1 Diabetes Mellitus and Hypothyroidism

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Other Title
  • 薬剤性過敏症症候群（DIHS）に劇症1型糖尿病と橋本病が続発した1例

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Description

A 64-year-old man presented with erythematous plaques on his trunk and extremities associated with high fever 13 days after administration of sulfamethoxazole/trimethoprim. He also had liver dysfunction, increased atypical lymphocytes, and an elevated HHV-6 IgG antibody titer for over two weeks. Histopathology revealed dense lymphocytic infiltrates in the dermis and edema in the epidermis. We diagnosed him with DIHS. He took 15mg of prednisolone/day for two days, but his erythematous plaques persisted. Therefore, we increased the dose of prednisolone to 0.5mg/kg/day (30mg/day) and all other drugs were discontinued. Twenty days after the appearance of his skin symptoms, he felt fatigue and a sense of thirst, and his heart rate increased. Blood tests demonstrated hyperglycemia, ketosis, and metabolic acidosis, and he developed fulminant type 1 diabetes. His skin eruptions disappeared, and the dose of prednisolone was tapered off. Six months later, however, erythematous plaques recurred. He also had elevated TSH and decreased FT4 levels on blood tests. He was diagnosed with hypothyroidism. This case demonstrates the importance of assessing autoimmune diseases associated with DIHS.Skin Research, 17: 57-61, 2018

Journal

  • Hifu no kagaku

    Hifu no kagaku 17 (2), 57-61, 2018

    Meeting of Osaka Dermatological Association/Meeting of Keiji Dermatological Association

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Details 詳細情報について

  • CRID
    1390564238052951552
  • NII Article ID
    130007530771
  • DOI
    10.11340/skinresearch.17.2_57
  • ISSN
    18839614
    13471813
  • Text Lang
    ja
  • Data Source
    • JaLC
    • CiNii Articles
  • Abstract License Flag
    Disallowed

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